For Applicant Sample Clauses

For Applicant.  Driver’s License  Passport/Visa  Other Issuer: ID Number: Date of Issuance (If applicable): Date of Expiration (If applicable):

For Applicant. ❑ Driver’s License ❑ Passport/Visa ❑ Other Issuer:_____ _ _ _ _ _ _ ID Number: ________ _ _ _ _ _ Date of Issuance (If applicable): ____ _ _ _ __ Date of Expiration (If applicable): _____

For Applicant. This agreement is by and between the County of Riverside, hereafter “County”, and PROPERTY / PROJECT INFORMATION Date: PARENT CASE # (Fast Track, TR, PM, PP, CUP, PUP, MS): PROJECT NAME: DESCRIPTION (Map & Phase # / No. of Lots): LOCATION (Address and Cross Street Name(s)): APN(s): Please designate who to contact to discuss the project. □ Applicant □ Engineer □ Property Owner ADDRESS CITY / STATE / ZIP CODE PHONE: CONTACT PERSON: (Last Name, First) FAX: E-MAIL ADDRESS: If your application is subject to Deposit–based Fee, the following applies

For Applicant. Aircraft Rated □ Component Rated □ JCAB AMO name: JCAB approval number: Address of AMO: Mailing Address: (if different than above): Tel: Fax: Main Contact E-mail:

For Applicant. Attn: ____________________ 0000 Xxxxx Xxxxxxxxx, Suite 500 Vienna, VA 22182 Attn: eHealth Exchange Program Director

For Applicant. Please select the type of application and complete section 3 of the Form. Initial □ Amendment □ a. Changes of Address □ b. Change of Accountable manager □ c. Change of organisation name □ TCCA CAR 573 AMO number: (as applicable only for amendment of a TCCA supplement. n/a if initial)

For Applicant.  Please forward this application together with the TCCA Supplement to your JCAB Regional Office.  Do not send any documents to TCCA.  The application must be sent at least 90 days prior to the date initial approval is required, or 60 days prior to the expiry date for Continuation.

For Applicant.  Please forward this application together with the TCCA Supplement to your UK CAA Regional Office.  Do not send any documents to TCCA.  The application must be sent at least 90 days prior to the date initial approval is required.