DIRECT DEPOSIT AUTHORIZATION Sample Clauses

DIRECT DEPOSIT AUTHORIZATION. If you wish to have any Advances directly deposited into your bank account, please attach a VOID cheque for the relevant account and sign and date the section below. If your financial institution requires the advance to be issued jointly, direct deposit is not possible. Producer Signature Date NO
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DIRECT DEPOSIT AUTHORIZATION. If you wish to have the advance deposited into your account, please attach a VOID cheque from your specific account and financial institution. If the financial institution requires the advance to be issued jointly, direct deposit is not possible. Signature of Producer Date Yes No ADVANCE RATES FOR COMMODITIES CROPS RATE/MT RATE/lb LIVESTOCK RATE/HEAD Bison Feeder (650-750 lbs) $852.39 Alfalfa $94.05 Bison Finished (900-1050 lbs) $1,178.10 Alfalfa Seed $0.89 Cattle Feeder Calf (400-700 lbs) $777.3975 Barley 92.07 Cattle Feeder Cattle (700-900 lbs) $894.96 Canola $217.80 Cattle Finished (900-1250 lbs) $891.2475 Corn $105.13 $2.6730 Cattle Finished Cattle (over 1250 lbs) $1,160.7750 Hay $69.30 Cattle Continuous Flow Feeder Calf (400-700) $776.61 Oats $123.75 Cattle Continuous Flow Feeder Cattle (700-900) $894.05 Peas $123.63 $.0561 Cattle Continuous Flow Finished Cattle (900-1250) $890.34 Rye Grass Seed Common $0.1733 Cattle Continuous Flow Finished Cattle (over 1250) $1,159.60 Rye Grass Seed Perennial $0.2723 Sheep $44.01 Bison Blended Weights $121.2750 ANIMALS RATE/HEAD Lambs (45 to 60 lbs) $48.46 Lambs (61 to 79 lbs) $58.84 Lambs (80 to 109 lbs) $74.67 Lambs (More than 110 lbs) $93.46 SPRING ADVANCE (includes Intended Seeding, Spring Livestock and Spring Stored Grain) GRAIN COMMODITIES Intended Seeding Advance Please include a valid confirmation of crop insurance – Coverage Detail/Crop Proposal. If using AgriStability, send your 2015 Enrolment Notice and the Calculation of Benefits for the Reference Margin . If you carry crop insurance you must use that as Security Security Type Commodity Crop Ins Ag Stab Land/Soil Type 2015 Intended Seeding Acres Production Insurance Coverage MT or lb/acre OR Coverage Level on AgStab Advance Rate Amount X X = X X = X X = X X = TOTAL OF PRE-HARVEST GRAIN COMMODITIES line 1 $ Advance Requested by Producer line 2 Eligible Advance (60% of lesser of line 1 or 2 above) A $ $ Stored Grain Advance Commodity Harvest Acres(Indicate year crop harvested in bracket) Stored Quantity (MT or lb) Against which Advance is Requested Advance Rate Amount ( ) X = ( ) X = ( ) X = ( ) X = TOTAL OF STORED GRAIN COMMODITIES $ Stored Grain Advance Requested By Producer B $ LIVESTOCK & ANIMAL COMMODITIES Producers must submit their 2015 AgriStability Enrolment Notice and Proof of Inventory using the latest Calculation of Program Benefits through AgriStability OR Inventory Sales from last year OR Schedule A from your most recent AgriStability applica...
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DIRECT DEPOSIT AUTHORIZATION. If you wish to have the advance directly deposited into your bank account, please attach a VOID cheque for the relevant account and sign and date the section below. If you already use direct deposit with CCGA and you intend to use the same account, you do not need to complete this section. If your financial institution requires the advance to be issued jointly, direct deposit is not possible. CCGA cannot direct deposit to a line of credit account. Signature of Producer Date FOR CCGA USE ONLY CCGA # Producer Information APP ID # Legal Name of Partnership, Corporation or Cooperative APP ID # Birthdate (MM/DD/YYYY) Full Legal Name of Individual, as on Birth Certificate (First name, Middle names, Surname) Name used when selling commodities Full Legal Name of person(s) authorized to exchange account information Relationship Telephone # SPRING ADVANCE (including Intended Seeding, Intended Honey Production, Spring Report for Winter Cereals, Spring Livestock and Spring Stored Grain) List only those commodities for which you are applying for an advance.
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DIRECT DEPOSIT AUTHORIZATION. If you wish to have any Advances directly deposited into your bank account, please attach a VOID cheque for the relevant account and sign and date the section below. If you already use direct deposit with WeCAP and you intend to use the same account, you do not need to complete this section. If your financial institution requires the advance to be issued jointly, direct deposit is not possible. Producer Signature Date
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DIRECT DEPOSIT AUTHORIZATION. I understand that Adecco’s method of payment is direct deposit, with pay statements provided electronically. Such statements can be viewed/copied/printed at xxx.xxxxxxxxx.xxx. I will provide Adecco with a voided cheque or a completed bank-printed deposit slip if and when I accept my first assignment with Adecco. I understand that there may be delays in receiving my pay if I fail to report my hours or report them late or for other reasons such as statutory holidays, acts of God, electronic failures and Adecco or bank errors. I am responsible for contacting my bank to verify deposits prior to trying to withdraw money. I understand that Adecco will not be responsible for any overdrafts on my account, and I release Adecco from any liability associated with the availability of funds, including but not limited to bank fees, penalties, interest charges or other costs. In case of overpayment (or error in payment), I authorize Adecco to either withdraw funds from my bank account or withhold any monies from future payments to me. If the foregoing is not possible, I agree to promptly repay Adecco by cheque or money order. I also authorize Adecco and my bank to communicate about the foregoing.
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DIRECT DEPOSIT AUTHORIZATION. If you wish to have the advance directly deposited into your account, please attach a VOID cheque from your specific account and financial institution. If you used direct deposit with CCGA previously for the same account and financial institution branch, you only need to sign and check the box below. If the financial institution requires the advance to be issued jointly, direct deposit is not possible. CCGA cannot direct deposit to a line of credit account. check box if used Direct Deposit previously Date Signature of Producer FOR CCGA USE ONLY CCGA # Producer Information SPRING ADVANCE (including Intended Seeding, Intended Honey Production, Spring Report for Winter Cereals, Spring Livestock and Spring Stored Grain) List only those commodities for which you are applying for an advance.
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DIRECT DEPOSIT AUTHORIZATION. IMPORTANT INSTRUCTIONS
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DIRECT DEPOSIT AUTHORIZATION. If you wish to have the advance directly deposited into your account, please attach a VOID cheque from your specific account and financial institution. If you used direct deposit with CCGA previously for the same account and financial institution branch, you only need to sign and check the box below. If the financial institution requires the advance to be issued jointly, direct deposit is not possible. CCGA cannot direct deposit to a line of credit account. check box if used Direct Deposit previously Date Signature of Producer FOR CCGA USE ONLY CCGA # Producer Information ACTUAL SEEDED PRE-HARVEST ADVANCE FOR WINTER CEREALS List only those commodities for which you are applying for an advance. Winter Wheat - $87.30 Fall Rye - $77.60 rates/mt Be sure to include a valid confirmation of crop insurance - All winter cereal applicants must use crop insurance as security. Security Type Crop Crop Ins. Land/Soil Type 2017 Seeded Acres Production Insurance Coverage MT/Acre CCGA Advance Rate/MT $ Amount Winter Wheat X X = Fall Rye X X = X X = X X = X X = X X = X X = total of above crops: (Maximum $ 400,000.00 ) line 1 $ Advance Requested by Producer Xxxxxxxx Advance (60% of line 2)
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DIRECT DEPOSIT AUTHORIZATION. I understand that Roevin’s method of payment is direct deposit, with pay statements provided electronically. I will provide Roevin with a voided cheque or a completed bank-printed deposit slip if and when I accept my first assignment with Roevin. I understand that there may be delays in receiving my pay if I fail to report my hours or report them late or for other reasons such as statutory holidays, acts of God, electronic failures and Roevin or bank errors. I am responsible for contacting my bank to verify deposits prior to trying to withdraw money. I understand that Roevin will not be responsible for any overdrafts on my account, and I release Roevin from any liability associated with the availability of funds, including but not limited to bank fees, penalties, interest charges or other costs. In case of overpayment (or error in payment), I authorize Roevin to either withdraw funds from my bank account or withhold any monies from future payments to me. If the foregoing is not possible, I agree to promptly repay Roevin by cheque or money order. I also authorize Roevin and my bank to communicate about the foregoing.
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Related to DIRECT DEPOSIT AUTHORIZATION

  • AGENT AUTHORIZATION FORM I/We, (Print Bidder name) , Do hereby authorize (print agent’s name), , to act as my/our agent to execute any petitions or other documents necessary to affect the CONTRACT approval PROCESS more specifically described as follows, (IFB NUMBER AND TITLE) , and to appear on my/our behalf before any administrative or legislative body in the county considering this CONTRACT and to act in all respects as our agent in matters pertaining TO THIS CONTRACT. Signature of Bidder Date STATE OF FLORIDA ) ) ss: COUNTY OF ) The foregoing instrument was acknowledged before me by means of ☐physical presence, or ☐online notarization, this day of , 20 , by [NAME OF PERSON], as [TYPE OF AUTHORITY,… e.g. officer, trustee, etc.)] for [NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED]. ☐Personally Known; OR ☐Produced Identification. Type of identification produced: . [CHECK APPLICABLE BOX TO SATISFY IDENTIFICATION REQUIREMENT OF FLA. STAT. §117.05] Notary Public My Commission Expires: (Printed, typed or stamped commissioned name of Notary Public) LEASED EMPLOYEE AFFIDAVIT I affirm that an employee leasing company provides my workers’ compensation coverage. I further understand that my contract with the employee leasing company limits my workers’ compensation coverage to enrolled worksite employees only. My leasing arrangement does not cover un-enrolled worksite employees, independent contractors, uninsured sub-contractors or casual labor exposure. I hereby certify that 100% of my workers are covered as worksite employees with the employee leasing company. I certify that I do not hire any casual or uninsured labor outside the employee leasing arrangement. I agree to notify the County in the event that I have any workers not covered by the employee leasing workers’ compensation policy. In the event that I have any workers not subject to the employee leasing arrangement, I agree to obtain a separate workers’ compensation policy to cover these workers. I further agree to provide the County with a certificate of insurance providing proof of workers’ compensation coverage prior to these workers entering any County jobsite. I further agree to notify the County if my employee leasing arrangement terminates with the employee leasing company and I understand that I am required to furnish proof of replacement workers’ compensation coverage prior to the termination of the employee leasing arrangement. I certify that I have workers’ compensation coverage for all of my workers through the employee leasing arrangement specified below: Name of Employee Leasing Company: Workers’ Compensation Carrier: A.M. Best Rating of Carrier: Inception Date of Leasing Arrangement: I further agree to notify the County in the event that I switch employee-leasing companies. I recognize that I have an obligation to supply an updated workers’ compensation certificate to the County that documents the change of carrier. Name of Contractor: Signature of Owner/Officer: Title: Date: INFORMATION FOR DETERMINING JOINT VENTURE ELIGIBILITY If the bidder is submitting as a joint venture, please be advised that this form MUST be completed and the REQUESTED written joint-venture agreement MUST be attached and submitted with this form. HOWEVER, IF THE BIDDER IS NOT A JOINT VENTURE, CHECK THE FOLLOWING BLOCK: ( ) NOT APPLICABLE

  • Credit Card Authorization TO THE EXTENT PERMITTED BY APPLICABLE LAW, YOU IRREVOCABLY AND UNCONDITIONALLY AUTHORIZE XXXXXXX TO CHARGE ALL AMOUNTS DUE UNDER THIS AGREEMENT TO ANY CREDIT CARD YOU PROVIDE TO US, AND YOU AGREE TO INDEMNIFY, DEFEND AND HOLD HARMLESS XXXXXXX WITH RESPECT TO THE SAME.

  • Medical Authorization In the event of illness or injury while participating in the above referenced activity, I hereby consent to whatever x-ray, examination, anesthetic, medical, surgical, dental diagnosis or treatment, hospital care and emergency transportation from a licensed physician, surgeon, and/or dentist as deemed necessary for my safety and welfare.

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