Attach. 🞏 Proof of Immunizations - a verified or documented copy of your child’s immunization record must be complete and up-to-date prior to being admitted to school. �� Commitment Fee ($150)
Attach a copy of a recent financial report for your organization (for example, your latest audit, your latest monthly or quarterly financial statement, the treasurer’s report from your latest approved board meeting minutes). Attach a copy of your DUNS number. You may obtain a DUNS number by visiting this website: xxxx://xxxxxx.xxx.xxx/webform. There is no charge for obtaining the number.
Attach a copy of this form to your Federal income tax return for the calendar year involved.
Attach. 🞏 Birth Certificate copy �� Proof of Immunizations 🞏 Transcripts – Gr. 1-8 (if available) – Placement Testing may be required if transcripts are not provided by parent and/or previous school and a non-refundable fee of $30.00 is required prior to testing. (See Kindergarten Placement Testing Information, #4 below). 🞏 Commitment Fee & PrePaid Tuition
Attach. 1 CRD Identifying Official Use Only Information Applies if contract involves activities where Official Use Only (OUO) information and documents will be handled, used or generated. DOE M 471.3-1
Attach a copy of your 501(c)(3) letter from the (RS.
Attach the Bottom shelf support Bar (DsyF13) to the back of the Front Wood Frame (DsyF11) using four 32 mm screws (DsyF2). Tighten fully, but be careful not to overtighten.
Attach three colour photocopies showing the vessel (side view),auxiliary fishing boats and auxiliary aerial equipment used to detect fish, — an illustration and detailed description of the fishing gear used, — a document proving that the representative of the shipowner is empowered to sign this application. ............................................ (Date of application) ............................................................................... (Signature of representative of shipowner) 27.12.2000 Appendix 2 FREEZER TRAWLERS (DEMERSAL SPECIES) EN Official Journal of the European Communities L 329/13 Month: Year: Name of vessel: Nationality (flag): Engine rating: Gross registered tonnage (t): Fishing method: Port of landing: Date Fishing area Number of catches Number of fishing hours Species of fish Longitude Latitude Totals
Attach a copy of a document reflecting the learner’s conditions of employment for learners who were not employed by the employer when the agreement was concluded as contemplated by section 18(2) of the Act. (for example: contract of employment, written particulars of employment.) Learner’s signature: Parent or Guardian’s signature (Only if the learner is a minor) Date: Date: Witness signature: Witness signature: Date: Date: Employer or Lead Employer’s signature Training Provider or Lead Training Provider's signature Date: Date: Witness signature: Witness signature:
Attach a blank (voided) check here. Anthem Blue Cross and Blue Shield is the trade name of: In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Ohio: Community Insurance Company. In Wisconsin: Blue Cross and Blue Shield of Wisconsin ("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association. MMWF3355A (6/08) Automatic Bank Draft Payments A real savings in time and money! Why write and mail checks for your health coverage? Let your bank do the paperwork for you automatically. With your authorization, your bank or financial institution deducts the amount of the premium from your account and automatically transfers that premium to Anthem Blue Cross and Blue Shield as it comes due. The amount of your premium payment will appear on your bank statement. And you can cancel this agreement at any time by contacting Anthem in writing or by a phone call, allowing Anthem Blue Cross and Blue Shield and the financial institution reasonable time to act upon your notification. How does automatic bank draft payment benefit me? ▪ You save the cost of checks and postage. ▪ You waste no time writing checks and posting the letters. ▪ Your payment is received on time, even if you are ill or away from home. ▪ You receive a record of payment on your bank statement. ▪ No bill will arrive in the mail. ▪ There is no service charge or fee for this service. Anthem will make all arrangements with your bank or financial institution for the automatic bank draft payment. Please allow six to eight weeks to process your authorization. Continue to pay as billed until receiving a confirmation l...
