SIGNATURE REQUIRED. I hereby acknowledge that this agreement is between the IRA Owner named in Step 1 and the Custodian and that Product and its affiliates (i) shall have no obligations or liability under this agreement or for any transactions executed in connection herewith; (ii) shall have no responsibility, discretion or involvement in evaluating or selecting assets or investments; and (iii) shall not be deemed to be a “fiduciary” as defined in the Employee Retirement Income Security Act of 1974, as amended, and/or Section 4975 of the Internal Revenue Code of 1986, as amended, with respect to any assets or property of the IRA account.
SIGNATURE REQUIRED. This authority is to remain in full force and effect until Pershing Advisor Solutions LLC has received written notification from me (or either of us) of its termination in such time and in such manner as to afford Pershing Advisor Solutions LLC and my (our) financial institution a reasonable opportunity to act on it. It is understood that if the period purchase of mutual funds is selected as a contribution type, this agreement authorizes payment for purchasing securities through my investment professional or financial organization via the systematic reinvestment system (SRS). I/we represent and warrant that each of us is an owner on the Bank Account and that each of us has full authority to cause funds to be withdrawn from the Bank Account and credited to the Pershing Advisor Solutions LLC account identified in Step 1. I/we understand that Xxxxxxxx is relying upon this representation in agreeing to permit the movement of funds via ACH between my/our Pershing Advisor Solutions LLC account and the Bank Account. Print Name Date — — Signature X ALL REGISTERED OWNERS ON YOUR PERSHING ADVISOR SOLUTIONS LLC ACCOUNT MUST SIGN IN STEP 7. Print Name Date — — Signature X Print Name Date — — Signature X EXAMPLES OF ACCEPTABLE NAME DIFFERENCES INCLUDE A BANK ACCOUNT USING MIDDLE INITIAL INSTEAD OF FULL NAME OR USING THE SUFFIX JR. OR SR. WHEN THE BROKERAGE ACCOUNT DOES NOT. Print Name Date — — Signature X Print Name Date — — Signature X
SIGNATURE REQUIRED. I hereby acknowledge that this agreement is between the IRA Owner named in Step 1 and the Custodian and that Product and its affiliates (i) shall have no obligations or liability under this agreement or for any transactions executed in connection herewith; (ii) shall have no responsibility, discretion or involvement in evaluating or selecting assets or investments; and (iii) shall not be deemed to be a “fiduciary” as defined in the Employee Retirement Income Security Act of 1974, as amended, and/or Section 4975 of the Internal Revenue Code of 1986, as amended, with respect to any assets or property of the IRA account. IRA Owner Signature Date BENEFICIARY CHANGE FORM Forward To: First Trust Retirement, c/o DST Systems, Inc. Please Print or Type Regular Mail Overnight Delivery PO Box 219002 Kansas City, MO 64121-9002 888-808-7348 Mail Stop: Lightstone Group REIT430 Xxxx 0xx XxxxxxXxxxxx Xxxx, XX 00000-0000
SIGNATURE REQUIRED. I, (print name) have read the terms and conditions of this contract found on the reverse side of this page and have reviewed the payment terms stated above. I understand that this contract is legally binding between CHI and my company. I am authorized to approve the terms of this contract.
SIGNATURE REQUIRED. Once submitted, contracts are binding. Prior to occupancy, this Contract must be signed and dated or electronically accepted as evidence of acceptance of the terms, conditions and regulations stated in this Contract. At the time of signing a contract, if the student is not 18 years old, a parent or legal guardian of the student will be required to cosign the Contract. Failure to check in, pick up a key, or occupy the assigned space does not release the student from this Contract.
SIGNATURE REQUIRED. I hereby acknowledge that this agreement is between the IRA Owner named in Step 1 and the Custodian and that Product and its affiliates (i) shall have no obligations or liability under this agreement or for any transactions executed in connection herewith; (ii) shall have no responsibility, discretion or involvement in evaluating or selecting assets or investments; and (iii) shall not be deemed to be a “fiduciary” as defined in the Employee Retirement Income Security Act of 1974, as amended, and/or Section 4975 of the Internal Revenue Code of 1986, as amended, with respect to any assets or property of the IRA account. IRA Owner Signature Date BENEFICIARY CHANGE FORM TERRA INCOME FUND 6, INC. Forward To: First Trust Retirement, c/o DST Systems, Inc. Please Print or Type Regular Mail Overnight Delivery PO Box 219686 Kansas City, MO 64121-9686 844-224-4712 Mail Stop: Terra Income Fund 0000 Xxxx 0xx XxxxxxXxxxxx Xxxx, XX 00000-0000
SIGNATURE REQUIRED. This Agreement shall be considered binding when signed by all Parties. However, Resident/Fellow shall not receive any portion of his/her salary or other benefits until all requirements, as outlined hereinabove, have been met. RESIDENT/FELLOW DATE PRESIDENT/XXXX DATE Reviewed and acknowledged by:
SIGNATURE REQUIRED. This Certificate is not valid unless signed by the Correspondent on the attached Declarations page. Correspondent Not Insurer. The Correspondent is not an Insurer under this Certificate and is not liable for any loss or claim whatsoever. The Insurers are those Underwriters at Lloyd’s, London whose syndicate numbers can be ascertained from the Correspondent. As used in this Certificate, “Underwriters” includes incorporated as well as unincorporated persons or entities that are Underwriters at Lloyd’s, London.
SIGNATURE REQUIRED. Joint & Several Liability 26-27 If applying as a partnership, corporation or cooperative, complete this form. Continuing Guarantee This form must be completed if the applicant: Signature Required (p. 27) 1. is applying for the first time, 2. resides in Alberta and has not received a CCGA advance since 2016,
SIGNATURE REQUIRED. This Agreement shall be considered binding when signed by all Parties. However, Resident/Fellow shall not receive any portion of his/her salary or other benefits until all requirements, as outlined hereinabove, have been met. RESIDENT/FELLOW DATE PROGRAM DIRECTOR DATE XXXX/REGIONAL XXXX DATE For Internal Use Only PIT/Full TX License Expires ACLS Expires DEA Expires Exhibit A – Lubbock Campus Benefits Insurance and Fringe Benefits
