ACKNOWLEDGEMENT; SIGNATURE. I, _______________________, in my capacity as ___________________ of the Issuer/Borrower/Selling Securityholder listed above and not in my individual capacity, hereby:
(a) acknowledge and authorize on behalf of the Issuer/Borrower/Selling Securityholder and each beneficial owner identified in paragraphs (c) and (d) of Section III above that this certification and the attachments hereto may be provided to each of the financial institutions involved in the applicable sale of securities or extension of credit;
(b) agree on behalf of the Issuer/Borrower/Selling Securityholder identified above, from the date hereof until the closing of the applicable sale of securities or the termination of the agreement providing for the applicable extension of credit, as the case may be, to notify each of the financial institutions involved in such transaction of any change in the information provided herein that would result in a change to the list of beneficial owners identified in paragraph (c) or (d) of Section III above;
(c) agree on behalf of the Issuer/Borrower/Selling Securityholder identified above, upon request by or on behalf of the financial institutions involved in the applicable sale of securities or extension of credit, to provide documentation supporting any applicable exclusion identified in Section II above; and
(d) certify, to the best of my knowledge, that the information provided above is complete and correct.
ACKNOWLEDGEMENT; SIGNATURE. I hereby agree to the terms and conditions set forth in this form and in the attached Common Stock Unit Agreement. In the event of any conflict between the terms of this form and the Common Stock Unit Agreement, I understand that the terms of the Common Stock Unit Agreement shall govern.
ACKNOWLEDGEMENT; SIGNATURE. I, in my capacity as _______________________________ of the Borrower listed above and not in my individual capacity, hereby:
(a) acknowledge and authorize on behalf of the Borrower and each beneficial owner identified in paragraphs (c) and (d) of Section III above that this certification and the attachments hereto may be provided to each of the financial institutions involved in the extension of credit;
(b) agree on behalf of the Borrower identified above, from the date hereof until the termination of the agreement providing for the extension of credit to notify each of the financial institutions involved in such transaction of any change in the information provided herein that would result in a change to the list of beneficial owners identified in paragraph (c) or (d) of Section III above;
ACKNOWLEDGEMENT; SIGNATURE. I, _______________________, in my capacity as ___________________ of the Issuer/Borrower/Selling Securityholder listed above and not in my individual capacity, hereby:
ACKNOWLEDGEMENT; SIGNATURE. I hereby make the election designated in this form, and agree to the terms and conditions set forth in this form and in the Series A Preferred Stock Unit Agreement to which this form is attached. In the event of any conflict between the terms of this form and the Series A Preferred Stock Unit Agreement, I understand that the terms of the Series A Preferred Stock Unit Agreement shall govern.
ACKNOWLEDGEMENT; SIGNATURE. I have read the Eastport-South Manor Central School District’s Internet Safety Acceptable Use Policy and consent to the terms and conditions included in the Student/Staff Use of Personal Computing Devices (BYOD) Agreement.
ACKNOWLEDGEMENT; SIGNATURE. I will notify the Federal agency immediately if all or a portion of the work authorized and funded under this award is subsequently funded by another Federal agency.
ACKNOWLEDGEMENT; SIGNATURE. I, , in my capacity as of the Issuer/Borrower/Selling Securityholder listed above and not in my individual capacity, hereby:
(a) acknowledge and authorize on behalf of the Issuer/Borrower/Selling Securityholder and each beneficial owner identified in paragraphs (c) and (d) of Section III above that this certification and the attachments hereto may be provided to each of the financial institutions involved in the applicable sale of securities or extension of credit;
(b) agree on behalf of the Issuer/Borrower/Selling Securityholder identified above, from the date hereof until the closing of the applicable sale of securities or the termination of the agreement providing for the applicable extension of credit, as the case may be, to notify each of the financial institutions involved in such transaction of any change in the information provided herein that would result in a change to the list of beneficial owners identified in paragraph (c) or (d) of Section III above;
ACKNOWLEDGEMENT; SIGNATURE. By signing this application and agreement, I/we acknowledge, agree, and /or certify that; (a) I (we) have read, understand, and agree to the terms in the Client Agreement for Trust Administration, (b) if applicable, under penalties or perjury that the social security number/tax ID number listed on this form is correct, (c) I/we will have the primary responsibility for communication regarding my account except as may be otherwise required by law, rule or regulation, including without limitation account statements, and as Preferred Trust Company may otherwise reasonably deem necessary, (d) I have been advised of fees related to the administration of my account, (e) I/we acknowledge that Preferred Trust Company will verify the information I provide on this application through a third-party provider in accordance with federal and state law. I/we authorize Preferred Trust Company to make inquiries for the purpose of verifying my/our identity. I/we further authorize Preferred Trust Company to disclose the results of such inquiries relating to the verification of my/our identity with my investment advisor. I/we understand that Preferred Trust Company may share this information with its affiliates to determine my eligibility for other products and services those affiliates may offer. I may opt out of such information by providing Preferred Trust Company with written notification, (f) I authorize Preferred Trust Company to act upon my direction. This Client Trust Administration Agreement shall remain in effect until revoked, modified or amended by the Client upon thirty (30) days written notice to the Trustee.
ACKNOWLEDGEMENT; SIGNATURE. I hereby acknowledge receipt of a copy of this agreement and accept the responsibilities listed herein as renter of the Scandia Senior Community Center. I understand that violation of the terms of this rental agreement may result in the denial of future use of the facilities. Renter Signature: Date: City Representative Signature: Date: Food Safety Orientation, if required: Date:
