Disclosure Statement and Privacy Notice Sample Clauses

Disclosure Statement and Privacy Notice. The Department of Child Safety, Youth and Women (the department) is collecting the personal information on this form for the purpose of assessing your application to become or continue to be a xxxxxx or kinship carer. This is authorised under the Child Protection Xxx 0000 and the Child Protection Regulation 2011. Your personal information will be managed in accordance with the Information Privacy Xxx 0000. Under the Children’s Court Rules 2016 and the Director of Child Protection Litigation Xxx 0000, the department is required to provide relevant information to the Director of Child Protection Litigation (DCPL) in relation to child protection proceedings, and the DCPL has a duty to disclose documents relevant to the proceeding to each other party. Therefore, any information provided to the department that may be relevant to current or future court proceedings may be provided to the parties, including the parents. This may include applications for future child protection orders for children already in your care as an approved xxxxxx or kinship carer, such as long-term Child Protection Orders. Queensland Xxxxxx and Kinship Care Support Line Telephone: 0000 000 000 Availability: Monday to Friday 5:00 pm – 11:30 pm Saturday and Sunday 7:00 am – 11:30 pm   Queensland Xxxxxx and Kinship Care (QFKC) Telephone: (00) 0000 0000 Email: FCQ – xxxxx@xxxx.xxx.xx Website: FCQ – xxx.xxxx.xxx.xx   Xxxxxx and Kinship Care Service   (please fill in contact details of local service supporting applicant/carer)  
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Disclosure Statement and Privacy Notice. You acknowledge receipt of a SMM Brochure and/or SPM Brochure (Form ADV, Part 2A), and a SPM/SMM Brochure Supplement at or before the execution of this Agreement. The parties have executed this Agreement, including the agreement to binding arbitration of disputes in Section 29 above, by their duly authorized representatives on , 20 .
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Disclosure Statement and Privacy Notice. You acknowledge receipt of Part 2 of Form ADV (the “Disclosure Statement”) and you acknowledge that you have reviewed and agree to Commandiv’s Privacy Policy (xxx.xxxxxxxxx.xxx/xxxxxxx) and Terms of Use (xxx.xxxxxxxxx.xxx/xxxxx) at or before the execution of this Client Agreement.
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Disclosure Statement and Privacy Notice. You acknowledge receipt of Part 2 of Form ADV (the “Disclosure Statement”) and the privacy notice at or before the execution of this Agreement. [The balance of this page is intentionally blank; the signature page follows immediately.] This Agreement, including the agreement to binding arbitration of disputes in Section 22, has been signed and delivered by their duly authorized representatives on the date indicated below. Client(s): Printed name and any representative capacity Client’s or representative’s signature Date Printed name and any representative capacity Client’s or representative’s signature (e.g., joint or co-trustee) Date Printed name and any representative capacity Client’s or representative’s signature (e.g., joint or co-trustee) Date (1) Designated Account Registration (Type) Account Number* Custodian Annualized IM Fee (2) Designated Account Registration (Type) Account Number* Custodian Annualized IM Fee (3) Designated Account Registration (Type) Account Number* Custodian Annualized IM Fee (4) Designated Account Registration (Type) Account Number* Custodian Annualized IM Fee (5) Designated Account Registration (Type) Account Number* Custodian Annualized IM Fee *Required for existing accounts
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Disclosure Statement and Privacy Notice. Registered investment advisors are required to provide their advisory clients and prospective clients with a written disclosure document, as set forth in SEC Rule 204-3. As a registered advisor, we comply with this requirement by providing advisory clients and prospective clients with Part 2A and 2B of our Form ADV before or at the time of entering into an advisory contract. Client hereby acknowledges that prior to entering into this advisory contract, the Investment Advisor Representative (IAR) has made you aware of how to access the firm’s Disclosure Document and Privacy Notice. Specifically, the IAR has informed you that delivery of these required documents is done electronically via links on the Advisor’s website at xxx.xxxxxxxxxxxx.xxx. The Disclosure Document is referred to as “Advisory Services – Firm Brochure”. The Disclosure Document discusses the scope of Advisor’s services, fees, qualifications of IAR and any corresponding conflicts of interest. The Privacy Notice is referred to as “Privacy Policy”. The Privacy Notice discusses the manner in which the firm protects your private information. Client acknowledges that upon accessing the documents on the website, he/she must provide the following information: first name, last name, email address, IAR first name and IAR last name. By initialing here, , client hereby consents to this form of delivery. Client also consents to receiving annual electronic delivery of these documents. By initialing here, , client does not consent to this delivery method and, instead, the IAR and client together will contact the home office for delivery, prior to signing the agreement. By initialing here, , client certifies that the IAR has delivered a paper copy.
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Related to Disclosure Statement and Privacy Notice

  • IDENTIFYING INFORMATION AND PRIVACY NOTIFICATION (a) FEDERAL EMPLOYER IDENTIFICATION NUMBER and/or FEDERAL SOCIAL SECURITY NUMBER. As a condition to NYSERDA’s obligation to pay any invoices submitted by Contractor pursuant to this Agreement, Contractor shall provide to NYSERDA its Federal employer identification number or Federal social security number, or both such numbers when the Contractor has both such numbers. Where the Contractor does not have such number or numbers, the Contractor must give the reason or reasons why the payee does not have such number or numbers.

  • Risk Disclosure Statement Counterparty represents and warrants that it has received, read and understands the OTC Options Risk Disclosure Statement provided by Dealer and a copy of the most recent disclosure pamphlet prepared by The Options Clearing Corporation entitled “Characteristics and Risks of Standardized Options”.

  • Disclosure Statement A disclosure statement of the Property signed and dated by the Seller;

  • Disclosure to FERC its Staff, or a State. Notwithstanding anything in this Article 22 to the contrary, and pursuant to 18 C.F.R. section 1b.20, if FERC or its staff, during the course of an investigation or otherwise, requests information from one of the Parties that is otherwise required to be maintained in confidence pursuant to this Agreement or the NYISO OATT, the Party shall provide the requested information to FERC or its staff, within the time provided for in the request for information. In providing the information to FERC or its staff, the Party must, consistent with 18 C.F.R. section 388.112, request that the information be treated as confidential and non-public by FERC and its staff and that the information be withheld from public disclosure. Parties are prohibited from notifying the other Parties to this Agreement prior to the release of the Confidential Information to the Commission or its staff. The Party shall notify the other Parties to the Agreement when it is notified by FERC or its staff that a request to release Confidential Information has been received by FERC, at which time the Parties may respond before such information would be made public, pursuant to 18 C.F.R. section 388.112. Requests from a state regulatory body conducting a confidential investigation shall be treated in a similar manner if consistent with the applicable state rules and regulations. A Party shall not be liable for any losses, consequential or otherwise, resulting from that Party divulging Confidential Information pursuant to a FERC or state regulatory body request under this paragraph.

  • Relationship Disclosure Form The purpose of this form is to document any relationships between a bidder to an Orange County solicitation and the Mayor or any other member of Orange County, Florida. This form shall be completed and submitted with the applicable bid to an Orange County solicitation.

  • Notice Regarding Material Contracts Promptly, and in any event within ten Business Days (i) after any Material Contract of Holdings or any of its Subsidiaries is terminated or amended in a manner that is materially adverse to Holdings or such Subsidiary, as the case may be, or (ii) any new Material Contract is entered into, a written statement describing such event, with copies of such material amendments or new contracts, delivered to Administrative Agent (to the extent such delivery is permitted by the terms of any such Material Contract, provided, no such prohibition on delivery shall be effective if it were bargained for by Holdings or its applicable Subsidiary with the intent of avoiding compliance with this Section 5.1(l)), and an explanation of any actions being taken with respect thereto;

  • Disclosure Updates Promptly and in no event later than 5 Business Days after obtaining knowledge thereof, notify Agent if any written information, exhibit, or report furnished to the Lender Group contained, at the time it was furnished, any untrue statement of a material fact or omitted to state any material fact necessary to make the statements contained therein not misleading in light of the circumstances in which made. The foregoing to the contrary notwithstanding, any notification pursuant to the foregoing provision will not cure or remedy the effect of the prior untrue statement of a material fact or omission of any material fact nor shall any such notification have the effect of amending or modifying this Agreement or any of the Schedules hereto.

  • NOTIFICATIONS AND SUBMISSION OF REPORTS Unless otherwise stated in writing after the Effective Date, all notifications and reports required under this IA shall be submitted to the following entities: Administrative and Civil Remedies Branch Office of Counsel to the Inspector General Office of Inspector General U.S. Department of Health and Human Services Xxxxx Building, Room 5527 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Facsimile: (000) 000-0000 LFAC: Xxxxxxx X. Xxxxx, DPM 0000 Xxxxxxxxxxx Xx. X-000 Xxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Email: xx.xxxxx@xxxxx.xxx Unless otherwise specified, all notifications and reports required by this IA may be made by electronic mail, overnight mail, hand delivery, or other means, provided that there is proof that such notification was received. Upon request by OIG, LFAC may be required to provide OIG with an additional copy of each notification or report required by this IA in OIG’s requested format (electronic or paper).

  • CONFIDENTIALITY AND PRIVACY POLICIES AND LAWS The Contractor shall comply to the extent applicable with all State and Authorized User policies regarding compliance with various confidentiality and privacy laws, rules and regulations, including but not limited to the IRS Publication 1075, Family Educational Rights and Privacy Act (FERPA), the Health Insurance and Portability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH). Contractor shall cooperate in executing a written confidentiality agreement under FERPA and/or a Business Associate Agreement (HIPAA/HITECH) or other contractual provisions upon request by the State or any Authorized User.

  • Identifying Information and Privacy NOTIFICATION (a) Identification Number(s). Every invoice or New York State Claim for Payment submitted to a New York State agency by a payee, for payment for the sale of goods or services or for transactions (e.g., leases, easements, licenses, etc.) related to real or personal property must include the payee's identification number. The number is any or all of the following: (i) the payee’s Federal employer identification number, (ii) the payee’s Federal social security number, and/or (iii) the payee’s Vendor Identification Number assigned by the Statewide Financial System. Failure to include such number or numbers may delay payment. Where the payee does not have such number or numbers, the payee, on its invoice or Claim for Payment, must give the reason or reasons why the payee does not have such number or numbers.

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