For Social Security Administration Sample Clauses

For Social Security Administration. (Signature) Xxx Xxxxxx Associate Commissioner, Office of Central Operations Date (Signature) Name: Title: Company Name: Date Attachment A – Form SSA-88‌ SAMPLE 24 of 45 Table of Conten User Agreement Between SSA and Requesting Party for CBSV Effective 10/1/14 Attachment B-1 – Form SSA 89‌ SAMPLE Attachment B-2 – Form SSA 89-S‌ Nombre en letra de molde Fecha de nacimiento Número de Seguro Social Quiero que esta información sea divulgada porque estoy llevando a cabo la siguiente transacción de negocios Razones para solicitar el CBSV: (Favor de marcar todo lo que aplique a esta divulgación) Empresa hipotecária con Investigación de antecedentes Investigación crediticia Empresa”): Servicios bancarios la siguiente empresa (“la Requisito para obtener una licencia Otra razón (explique) SAMPLE Nombre de la Empresa Dirección Yo autorizo a la Administración del Seguro Social a que verifique mi nombre y número de Seguro Social (SSN, sus siglas en inglés) a la Empresa o al agente de la Empresa, si procede, para el propósito que he identificado. El nombre y la dirección del agente de la Empresa es: Yo soy la persona a quien el número de Seguro Social fue emitió o el representante legal de un menor o el representante legal de una persona quien ha sido declarado por la corte un adulto incompetente. Yo declaro y afirmo bajo xxxx de perjurio que la información contenida aquí es verdadera y correcta. Yo reconozco que si hago alguna representación, que yo sé que es falsa, para obtener información de los registros del Seguro Social, puedo ser declarado culpable de un delito menor y penalizado con una multa de hasta $5,000. Este consentimiento xx xxxxxx por xxxx de la fecha en que es firmado. (Sus iniciales, por favor.) Firma Fecha en que firmó Parentesco (si no es la persona a quien le pertenece el SSN): Información de contacto de la persona que firma esta autorización: Dirección Cuidad/Estado/Zona Postal Número telefónico Formulario SSA-89 (Página 1 de 2)
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For Social Security Administration. Date __________ (Signature) Printed Name: Xxxxxxx Xxxxxxxxxxx Associate Commissioner, Office of Data Exchange & Policy Publications _________________________________________ Date ___________ (Signature) Printed Name: ______________________________ Title: _____________________________________ Company Name: ____________________________ Nombre en letra de molde ______________________________________ Fecha de nacimiento_____________ Número de Seguro Social ____________________________________________________________________ Quiero que esta información sea divulgada porque estoy llevando a cabo la siguiente transacción de negocios Razones para solicitar el CBSV: (Favor de marcar todo lo que aplique a esta divulgación) Empresa hipotecária ___________ Servicios bancarios_________ Investigación de antecedentes _________ Requisito para obtener una licencia______ Investigación crediticia ________________ Otra razón (explique)______________________ SAMPLE con la siguiente empresa (“la Empresa”): Nombre de la Empresa Dirección Yo autorizo a la Administración del Seguro Social a que verifique mi nombre y número de Seguro Social (SSN, sus siglas en inglés) a la Empresa o al agente de la Empresa, si procede, para el propósito que he identificado. El nombre y la dirección del agente de la Empresa es: Yo soy la persona a quien el número de Seguro Social fue emitió o el representante legal de un menor o el representante legal de una persona quien ha sido declarado por la corte un adulto incompetente. Yo declaro y afirmo bajo xxxx de perjurio que la información contenida aquí es verdadera y correcta. Yo reconozco que si hago alguna representación, que yo sé que es falsa, para obtener información de los registros del Seguro Social, puedo ser declarado culpable de un delito menor y penalizado con una multa de hasta $5,000. Firma ___________________________________ Fecha en que firmó _________________________________ Parentesco (si no es la persona a quien le pertenece el SSN): _________________________________________ Información de contacto de la persona que firma esta autorización: Dirección ________________________________________________________________________________ Cuidad/Estado/Zona Postal __________________________________________________________________ Número telefónico __________________________________________________________________ Formulario SSA-89 (Página 1 de 2)
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For Social Security Administration. Date __________ (Signature) Xxx Xxxxxx Associate Commissioner, Office of Central Operations _________________________________ Date __________ (Signature) Name: ________________________________ Title: _______________________________________ Company Name: ______________________________ Attachment A – Form SSA-88 Form Approved OMB #0960-0760 Name of the Company Company Address (P.O. Box alone is not acceptable) Address Line 1 __________________________________________________ Xxxxxxx Xxxx 0 __________________________________________________ Xxxx, Xxxxx, Xxx __________________________________________________ EIN (Employer Identification Number) (Provide primary EIN if your company uses more than one.) Designated email mailbox for receipt of technical bulletins from SSA: __________@________. Please note, the SSA will only send technical bulletins to one email address per company. You may provide this information later if you do not have one now. EMPLOYEE(S) AUTHORIZED TO USE CBSV List the names of all employees unless your company will access CBSV solely through a web service platform. Note: If your company will access CBSV solely through a web service platform, please provide corresponding information of the Responsible Company Official as the employee authorized to use CBSV. Name of Employee(s) Authorized to Use CBSV: Telephone Number of Employee(s) Authorized to Use CBSV: (include area code) Email Address of Employee(s) Authorized to Use CBSV: 7. ______________________________________ Name of Responsible Company Official (print or type) ______________________________________ Signature of Responsible Company Official ______________________________________ _________________ Title Date ______________________________________ Telephone Number (include area code) ______________________________________ Email Address See SSA’s CBSV User Guide for information regarding the extent and nature of employee’s authority to use CBSV. Notify us if your authorized employee leaves your company or if you choose to revoke any or all of your employee's authorization to use SSA's Business Services Online (BSO). The Social Security Administration (SSA) is allowed to collect the information on this form under Sections 205 and 1106 of the Social Security Act and the Privacy Act of 1974 (5 U.S.C. § 552a). We need this information to register your company and your authorized employee(s) to use our system for verifying Social Security Numbers and to contact you, if necessary. Giving us ...
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For Social Security Administration. (Signature) Xxx Xxxxxx Associate Commissioner, Office of Central Operations Date (Signature) Name: Title: Company Name: Date Attachment A – Form SSA-88 Form Approved OMB #0960-0760‌
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For Social Security Administration. (Signature) Xxx Xxxxxx Associate Commissioner, Office of Central Operations Date (Signature) Name: Title: Company Name: Date Social Security Administration Form Approved OMB No. 0960-0760 Printed Name: Date of Birth: Social Security Number: I want this information released because I am conducting the following business transaction: Reason (s) for using CBSV: (Please select all that apply) Mortgage Service Background Check Credit Check Banking Service License Requirement Other with the following company ("the Company"): Company Name: Company Address: I authorize the Social Security Administration to verify my name and SSN to the Company and/or the Company's Agent, if applicable, for the purpose I identified. The name and address of the Company's Agent is: I am the individual to whom the Social Security number was issued or the parent or legal guardian of a minor, or the legal guardian of a legally incompetent adult. I declare and affirm under the penalty of perjury that the information contained herein is true and correct. I acknowledge that if I make any representation that I know is false to obtain information from Social Security records, I could be found guilty of a misdemeanor and fined up to $5,000. Signature Date Signed Relationship (if not the individual to whom the SSN was issued): Contact information of individual signing authorization: Address SSA is authorized to collect the information on this form under Sections 205 and 1106 of the Social Security Act and the Privacy Act of 1974 (5 U.S.C. § 552a). We need this information to provide the verification of your name and SSN to the Company and/or the Company's Agent named on this form. Giving us this information is voluntary. However, we cannot honor your request to release this information without your consent. SSA may also use the information we collect on this form for such purposes authorized by law, including to ensure the Company and/or Company's Agent's appropriate use of the SSN verification service. S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 3 minutes to complete the form. You may send comments on our time estimate above to: SSA, 0000 Xxxxxxxx Xxxx., Xxxxxxxxx, XX 00000-0000. Send to this address only comments relating to our time estimate, not the completed form. The Company and/or its Agent have entered i...
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Related to For Social Security Administration

  • PAY ADMINISTRATION 43.01 Except as provided in this Article, the Public Service Terms and Conditions of Employment Regulations, and the Regulations Respecting Pay on Reclassification and Conversion as these Regulations exist on the date of the signing of this Agreement governing the application of pay to employees are not affected by this Agreement. 43.02 An employee is entitled to be paid for services rendered at: (a) the pay specified in Appendix A for the classification of the position to which the employee is appointed, if the classification coincides with that prescribed in the employee's document of appointment, or (b) the pay specified in Appendix A for the classification prescribed in the employee's document of appointment, if that classification and the classification of the position to which the employee is appointed do not coincide. (a) The rates of pay set forth in Appendix A shall become effective on the dates specified therein. (b) Where the rates of pay set forth in Appendix “A” have an effective date prior to the date of signing of this Agreement, the following shall apply: (i) “retroactive period” for the purpose of sub-paragraphs (ii) to (iv) means the period from the effective date of the revision up to and including the day before the collective agreement is signed or when an arbitral award is rendered therefore; (ii) a retroactive upward revision in rates of pay shall apply to employees, including initial appointments, former employees or in the case of death, the estates of former employees who were employees in the bargaining unit during the retroactive period; (iii) for promotions, demotions, deployments, transfers or acting situations effective during the retroactive period, the rate of pay shall be recalculated, such that the recalculated rate of pay equals the sum of the rate of pay the employee was previously receiving, plus any retroactive upward revision to that previous rate of pay, plus the same percentage increase, if any, in the rate of pay that the employee received at the time of promotion, demotion, deployment, transfer, or acting situation; (iv) no payment nor notification shall be made pursuant to paragraph 43.03(b) for one dollar ($1.00) or less. 43.04 When an employee is required by the Employer to perform the duties of a higher classification level on an acting basis for a period of at least five (5) consecutive working days, the employee shall be paid acting pay calculated from the date on which the employee commenced to act as if he or she had been appointed to that higher classification level for the period in which he or she acts. When a day designated as a paid holiday occurs during the qualifying period, the holiday shall be considered as a day worked for purposes of the qualifying period.

  • Policy Administration The Company shall provide all required, necessary and appropriate claims, administrative and other services with respect to the Policies. The Company shall use reasonable care in its administration and claims practices with respect to the Policies and in administering and performing its duties under this Agreement and such practices, administration and performance shall (a) conform with Applicable Law; (b) not be fraudulent; and (c) be no less favorable than those used by the Company with respect to other policies of the Company not reinsured by the Reinsurer.

  • Salary Administration Section 1. Salary eligibility date is defined as the date an employee is eligible for an annual performance pay increase. The salary eligibility date is computed from the date of hire. Employees shall be eligible for annual performance pay increases on the employees' salary eligibility date provided the employee is not at the top step of the salary range of the employees' classification. The employee may be denied the annual performance pay increase if there has been a serious performance or attendance problem. Denials are subject to review within six (6) months. Denials may be grieved under the provisions of Article 51. Section 2. Any employee requiring an emergency draw shall be authorized once during the term of this Agreement to make such a draw without explanation. Additional draws may be requested in accord with existing policy and will be considered on a case-by-case basis.

  • Social Security (check one)‌

  • Employment and Training Administration The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved.

  • REGULATORY ADMINISTRATION SERVICES BNY Mellon shall provide the following regulatory administration services for each Fund and Series:  Assist the Fund in responding to SEC examination requests by providing requested documents in the possession of BNY Mellon that are on the SEC examination request list and by making employees responsible for providing services available to regulatory authorities having jurisdiction over the performance of such services as may be required or reasonably requested by such regulatory authorities;  Assist with and/or coordinate such other filings, notices and regulatory matters and other due diligence requests or requests for proposal on such terms and conditions as BNY Mellon and the applicable Fund on behalf of itself and its Series may mutually agree upon in writing from time to time; and

  • Unemployment Insurance Unemployment Insurance coverage will be provided during the life of this Agreement for regular and auxiliary employees who would, if employed by a private employer, be eligible for such coverage under the provisions of the Unemployment Insurance Act.

  • Health Insurance Benefits To the extent provided by the federal COBRA law or, if applicable, state insurance laws, and by the Company’s current group health insurance policies, Executive will be eligible to continue Executive’s group health insurance benefits at Executive’s own expense. If Executive timely elects continued coverage under COBRA, the Company shall pay Executive’s COBRA premiums, and any applicable Company COBRA premiums, necessary to continue Executive’s then-current coverage for a period of 12 months after the date of Executive’s termination of employment; provided, however, that any such payments will cease if Executive voluntarily enrolls in a health insurance plan offered by another employer or entity during the period in which the Company is paying such premiums. Executive agrees to immediately notify the Company in writing of any such enrollment. Notwithstanding the foregoing, if the Company determines, in its sole discretion, that it cannot provide the foregoing benefit without potentially incurring financial costs or penalties under applicable law (including, without limitation, Section 2716 of the Public Health Service Act), the Company shall in lieu thereof provide to Executive a taxable monthly amount to continue his group health insurance coverage in effect on the date of separation from service (which amount shall be based on the premium for the first month of COBRA coverage), which payments shall be made regardless of whether Executive elects COBRA continuation coverage and shall commence in the month following the month in which Executive incurs a separation from service and shall end on the earlier of (x) the date on which Executive voluntarily enrolls in a health insurance plan offered by another employer or entity during the period in which the Company is paying such amounts and (y) 12 months after the date of Executive’s separation from service.

  • Group Health Insurance The Employer shall provide a comprehensive health care insurance program for all permanent full-time and part-time employees. Health Plan characteristics and benefits shall be as provided in the Employer’s Agreement with the Ohio Civil Service Employees Association (hereinafter OCSEA). Regardless of the plan, employees will pay fifteen percent (15%) of the premium and the Employer will pay eighty-five percent (85%) of the premium; however for any alternative plans offered pursuant to the Agreement with OCSEA, the employees’ premium share will be determined by the Director of DAS, but will not exceed fifteen percent (15%) of the premium. The Employer’s premium share shall be paid on behalf of eligible employees as provided in the Employer’s Agreement with OCSEA. Employees who include a spouse as a dependent for healthcare coverage shall pay a surcharge as provided in the Employer’s Agreement with OCSEA. Eligibility provisions for employees enrolling in State provided health care plans shall remain the same as those in effect in the Employer’s Agreement with OCSEA. The Employer reserves the right to perform dependent eligibility audits upon recommendation of the Joint Health Care Committee. Health care costs paid on behalf of ineligible dependents will be subject to recovery. Deductibles, co-payments, and other plan design provisions for all benefit programs shall be the same as those prescribed in the Employer’s Agreement with OCSEA. Every year the Employer shall conduct an open enrollment period, at which time employees shall be able to enroll in a health plan, continue enrollment in their current plan, switch to another plan, subject to plan availability in their area, or waive coverage. The timing of the open enrollment period shall be established by the Director of the Department of Administrative Services (DAS), in consultation with the Joint Health Care Committee. Changes outside of open enrollment may only occur as prescribed in the Employer’s Agreement with OCSEA. Open Enrollment Fairs shall be held in accordance with Employer’s Agreement with OCSEA. There shall be established a Joint Health Care Committee composed of representatives of management, and of the various labor Unions representing State employees. The Committee shall meet regularly to monitor the operation of the State’s health care plans, and to make recommendations for the improvement of the plans and cost containment procedures. The Employer shall provide funding for dental, vision and the life benefits as described in Article 21 of the Employer’s Agreement with OCSEA and the Union’s Benefits Trust. Employee health insurance payments will be deducted from every paycheck. In the event an employee is receiving disability leave or Workers’ Compensation benefits, the Employer- policyholder shall continue, at no cost to the employee, the coverage of group health insurance for such employee for the period of such leave, but not beyond twelve (12) months. If the employee’s leave extends beyond twelve

  • Reinsurance Administration A. Within thirty (30) days after the end of each calendar month, the Cedent shall take all reasonable and appropriate steps to furnish the Reinsurer with a seriatim electronic report, as detailed in Schedule C, for each Reinsured Contract, valued as of the last day of that month. On or before September 30, 2001, the Cedent shall provide the initial seriatim electronic report, which shall cover the period from the Effective Date hereof through August 31, 2001; provided, however, that the initial seriatim electronic report may omit Funding Vehicle Values by MorningStar designation. The Cedent shall provide complete seriatim electronic data, as required herein, on or before April 30, 2002. Failure to provide this information as required shall constitute a material breach within the scope of Article XX, Paragraph G. B. Additionally, within thirty (30) days after the end of each calendar month the Cedent shall furnish the Reinsurer with a separate Summary Statement containing the following: 1. Reinsurance Premiums due to the Reinsurer summarized separately for each premium class by GMDB, EPB, and Income Program, as shown in Exhibit II; 2. benefit claim recoverables due to the Cedent in total and, if applicable, broken down by VNAR, SCNAR, and EEMNAR and Income Program; and 3. the month end date for the period covered by the Summary Statement. C. If the net balance is due to the Reinsurer, the Cedent shall remit the amount due with the Summary Statement, but no later than thirty (30) days after the month end date for the period covered by the Summary Statement. If the net balance is due to the Cedent, the Reinsurer shall remit the amount due to the Cedent within ten (10) days after receipt of the Summary Statement. D. The payment of Reinsurance Premiums is a condition precedent to the liability of the Reinsurer under this Agreement. In the event that the Cedent does not pay the Reinsurance Premiums in a timely manner, as defined below, the Reinsurer may exercise the following rights: 1. The Reinsurer shall charge interest if Reinsurance Premiums are not paid within thirty (30) days of the due date, as defined in Paragraph C of this Article. The interest rate charged shall be based on the ninety-(90) day federal Treasury Xxxx, as published in The Wall Street Journal on the first business day in the month following the due date of the Reinsurance Premiums, plus one hundred (100) basis points. The method of calculation shall be simple interest (360-day year). 2. The Reinsurer may terminate this Agreement in the event that Reinsurance Premium payments are more than sixty (60) days past due after the due date, as described in Paragraph C of this Article, by giving sixty (60) day written notice of termination to the Cedent. As of the close of the last day of this sixty-(60) day notice period, the Reinsurer's liability with respect to the ceded liabilities shall terminate. If all Reinsurance Premiums that are the subject of a sixty (60) day termination notice shall have been received by the Reinsurer within the time specified, the termination notice shall be deemed vacated and the Agreement shall remain in effect.

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