Client’s Signature. In his/her personal capacity and legal guardian of the following minor child/children (if applicable) # FULL NAMES IDENTITY / PASSPORT NUMBER 1. 2. 3. ANNEXURE ‘D’ – AGENT APPLICATION FORM Main Contact Full Names & Surname: Identity / Passport Number: Telephone Number (Work/House): Cell phone Number: Facsimile Number: Email Address: Physical Address: Capacity: Xxxx with (X): Personal: Representative of: Company: Trust: IF ACTING ON BEHALF OF A COMPANY / TRUST: Full name of Company / Trust: Registration Number of Company / Master’s Reference of Trust: VAT Number (if applicable):
Client’s Signature. Date: On behalf, and as President of, August Road Design: Date: February 23, 2016 Payment Schedule and Terms • Payment for project total will be made over the course of separate payments. • March 1, 2016: $2,500
Client’s Signature. Date………………..
Client’s Signature. Signed at __________________ on this _____day of ___________________20____ by the Contractor who warrants his/her authority to enter into this agreement. Contractor's Signature: _______________________________ Lawn Care Schedule ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
Client’s Signature. Date: You will get from your workouts what you put in. You are the only one who can make sure you work out consistently, eat properly, rest enough, and live a healthy lifestyle. CLIENT INFORMATION First Name Last Name Date Age Date of Birth / / Gender Type of Membership: Student Faculty/Staff Other: Address Preferred Phone Number Email Physician’s Name Physician’s Number PERSONAL MEDICAL HISTORY Have you had any past operations, hospitalizations, disabilities, diseases or are you currently under a physician’s care: Height Weight Desired Weight Have you ever been diagnosed with the following? Please check all that apply and write the date and a description below.
Client’s Signature. Date : Corporate Brokers Limited
Client’s Signature. The signature of the Client will obligate him or her to the conditions of this agreement for the specified term(s). Therefore, it is recommended that an adequate amount of time is set aside so that both Signature Parties may review this paperwork to satisfaction. When ready, the Client or the Authorized Signature Representative of the Client must sign this document then produce the current date. (22) Printed Name Of Client. After signing this agreement, the Client must furnish the printed version of his or her name to the remaining line in his or her signature area. (23) Service Provider’s Signature. The next signature area will call for the Service Provider named in the First Section to accept the conditions and terms of this agreement by signing his or her name and documenting when he or she performed this action by entering the date of signing. (24)
Client’s Signature. The scope and amount to be billed may be disputed by the Client, upon a written complaint delivered within 30 days since the xxxx is issued. Delivering the written complaint does not affect the maturity of the xxxx. All payments hereunder may be executed via a payment card or via wire transfer. One of the options of enforcement of debt that the Agent may make use of is an agreed set off as per § 1982 of the Civil Code. If the third country fiscal authority sends the Client’s refund to the bank account of this Agent and the Client does not pick up the refund within 45 days since an email notification is delivered to him/her, the Agent is entitled to charge a fee for administration of the refund in the amount of 4 % from the refund for each calendar month of said administration. All fees payable prior to the receipt of any refund from the third country include the VAT in a valid rate. All fees payable after the receipt of any refund are further subject to VAT rate applicable at the moment when the given fee is payable.
