Financial Representative Clause Samples
Financial Representative. You are required to advise Facility as to the identity of any and all individuals who you have authorized to act on your behalf as to financial matters and who have control over and access to your income and/or accounts, such as Social Security, pension income, investment interest, securities, annuities, cash and/or other funds. Each such individual shall be known as a Financial Representative (“FR”). The FR may be your Attorney-in-Fact, DR, or other legally appointed representative and you agree to provide the Facility with a copy of all such legal documents reflecting such status, such as a Power of Attorney. You agree that each such FR shall execute and adhere to the terms and conditions stated within the accompanying “Financial Responsibility Agreement” with the Facility. Your FR shall cooperate with Facility in obtaining timely payment from available funds and to assist you in applying for all payment programs to which you may be entitled (such as Medicaid). You further agree to immediately notify Facility if you revoke any such FR designation.
Financial Representative. Each party shall appoint one (1) representative with expertise in the areas of accounting, cost allocation, budgeting and financial reporting (each, a “Financial Representative”) no later than [ …***…] after the Effective Date. Such Financial Representatives shall consult with the JSC, in order to address the financial, budgetary and accounting issues that arise in connection with the Biocon Preclinical Activities. Each Financial Representative may be replaced at any time by the represented party by providing notice thereof to the other party. The Financial Representatives will meet as they or the parties, through the JSC, may agree is appropriate.
Financial Representative. Name of Power of Attorney: (Please include a copy of the Power of Attorney form.) Relationship: Phone Number: If there is no Power of Attorney, list who is responsible for applicant’s financial affairs: Name: Relationship: Phone Number: