Office Use Only Unit Size Requested Unit Number Targeted Move-In Date Date Received Time Received _C__o__k_a__t_o__P__a__r_k_v__i_e_w____________________________ _2__6_0___T__h_i_r_d__S__t_r_e__e_t__S__o__u_t_h__w__e__s_t_____________ _C__o__k_a__t_o_,__M___N___5_5__3_2__1_________________________ _P__h__:_(_3__2__0_)__9__0_5__-_2__8_7__4________________________ APPLICANT INFORMATION Applicant Name (Head of Household): Address: Social Security Number: Date of Birth: [ ] Male [ ] Female [ ] Decline Applicant Phone #: Applicant Email: Alternate Phone #: Alternate Email: Emergency Contact: List All Other Household Members First MI Last Relationship to Head Date of Birth Male/Female/ Decline to Answer Social Security Number [ ]M [ ]F [ ]Decline [ ]M [ ]F [ ]Decline [ ]M [ ]F [ ]Decline [ ]M [ ]F [ ]Decline [ ]M [ ]F [ ]Decline [ ]M [ ]F [ ]Decline Primary Language: Do you require an interpreter? [ ] Yes [ ] No How did you hear about this housing? [ ] Online [ ] Newspaper [ ] Local Agency [ ] Drive By [ ] Resident Referral [ ] Other What is the combined gross monthly income of all household members? $ ADDITIONAL HOUSEHOLD MEMBERS CURRENT HOUSING STATUS How long have you lived at your current address? From: To: Is this family or a friend? [ ] Yes [ ] No Name of Owner/Manager: Phone #: Email: Address: Do all adult household members live at this address?........................................................................................................................ [ ] Yes [ ] No If NO, include additional adult household’s current address and contact information on a separate piece of paper. PREVIOUS HOUSING STATUS Your previous address: How long did you live at your previous address? From: To: Is this family or a friend? [ ] Yes [ ] No Name of Owner/Manager: Phone #: Email: Address: List every state in which each household member has lived: ELIGIBILITY INFORMATION
Personal Use I agree that the pupil will only use this device for educational purposes and not for personal use and will not loan the equipment to any other person.
Residential Use; Pets The bedroom space and apartment may be used solely for private residential purposes and for no other purposes. Resident may not carry on any business or other enterprise from the bedroom space or apartment, nor use any Owner- provided Internet connections for business purposes. Resident may place no signs, placards or other advertisement of any character in the bedroom space or apartment, nor display anything in an apartment or bedroom space that is visible from outside the Property or the apartment. Resident may not store at the Property or connect to a Property electrical outlet any mobility device owned by a third party. Pets are permitted in or about the Property only in specified buildings as Owner may in its discretion allow residents to maintain, in each case only following Owner's signature on a Pet Addendum for a single dog or cat per designated apartment, which requires payment of a registration fee and pet rent as provided in the Pet Addendum. All other pets are prohibited anywhere at the Property, except fish in small tanks to the extent approved by Owner in its sole discretion. Violation of the pet policy will subject Resident to deep-cleaning and daily administration fees in Owner’s discretion and may be considered as a termination of this Housing Agreement by Resident.
Use of the Card 1. The Cardmember must sign the Card in ink, using a ball point pen, as soon as he or she receives it; the Cardmember must also safeguard the Card and preserve any PIN in extreme secrecy and keep it separate from his or her Card. The Cardmember must not use the Card after the expiration of the validity period embossed on it, and not use the Card after it has been damaged, withdrawn or cancelled.
2. Although the Cardmember has the right to use the Card, the Card shall at all times remain the property of AEME. The Cardmember must surrender the Card immediately upon any request by AEME, any Service Establishment or any other representative of AEME, based on AEME's instructions. A Service Establishment or any other representative of AEME may at its discretion, and after instructions by AEME, withdraw, hold and keep the Card on behalf of AEME.
3. The Cardmember is the only person authorized to use the Card for Transactions including Cash Withdrawals, identification or any other purpose. The Cardmember must not allow any other person to use the Card or the PIN. The Cardmember must safeguard the Card from misuse by retaining the Card under his or her personal control at all times.
4. The Card is issued to the Cardmember solely for the purposes of Transactions and Cash Withdrawals on behalf of the Company.
5. If the Cardmember uses the Card to buy goods or services from a Service Establishment on a frequent or recurring basis (e.g. subscription to periodicals, TV channels, and the like) ("Recurring Charges") or if the Cardmember uses the Card to buy goods or services on installments or on a premium basis (e.g. insurance) the Cardmember authorizes AEME to pay all such Recurring Charges or periodical premiums or installments on his or her behalf at the request of the Service Establishment, and the Company undertakes to repay AEME accordingly. The Cardmember must inform the Service Establishment and AEME in writing if the Cardmember wishes to stop any such periodical payments. AEME shall not be responsible for any breach, cancellation or termination of any legal arrangement or relationship (e.g. insurance policy) resulting from AEME's inability to pay the said Charges because the Cardmember's Account is in overdue status. AEME shall not be liable for any damages of any nature if AEME fails to pay or delays the payment of any Charges, installments or premiums because of any technical failure, error or for any reason beyond AEME's reasonable control.
6. Owners of Service Establishments who are Cardmembers are not allowed to use their Cards in their own Service Establishments. The Cardmember is not allowed to utilize the Card to fund any part of, or to meet the working capital requirements of his or her business.
7. The Company is solely liable for all amounts due on the Account and for all Charges incurred on the Card issued to the Cardmember.
8. The Cardmember is not entitled to use the Card to withdraw or extract cash in Service Establishments, and shall only use the Card to purchase goods or services.
9. The Cardmember shall not use the Card as payment for any illegal or unlawful purchases or services and is responsible for any use that is in violation of any local or other laws and regulations. The Cardmember further agrees to indemnify AEME for any action whatsoever that may arise as a result of such Transactions.
10. The Cardmember expressly authorizes AEME to use the information provided by the Cardmember for AEME's targeted promotional activities including without limitation, promotional activities conducted in conjunction with third parties selected by AEME, for third party researches and surveys, in accordance with the limitations of the applicable laws.
11. The Cardmember agrees to follow the Card activation procedures laid down by AEME from time to time and shall also be subject to any identity checks and verifications by AEME and or any third parties (e.g. credit bureaus, government agencies, Service Establishments, etc).
12. All Charges will be debited to the Account in the billing currency (i.e. USD). Any Transactions that are effected in currencies other than the billing currency will be debited to the Account after conversion as set forth in Clause 4.
Commercial Use Use of the Licensed Materials for the purposes of monetary reward (whether by Member Institutions, Authorized Users or Walk-in Users) by means of sale, resale, loan, transfer, hire or other form of commerce. For the avoidance of doubt, recovery of direct costs incurred by the Member Institution in the course of providing access to Authorized Users or Walk-in Users (e.g. printing, photocopying, or administration fee) including inter-library loan, is not deemed to be Commercial Use.
Residential Use Use the Apartment for residential purpose only. Under no circumstances shall the Allottee use or allow the Apartment to be used for commercial, industrial or other non-residential purposes. The Allottee shall also not use or allow the Apartment to be used as a religious establishment, hotel, guesthouse, service apartment, mess, hostel, boarding house, restaurant, nursing home, club, school or other public gathering place.
For Office Use Only Ref No )
Internet Use Customer assumes total responsibility for its and its users’ use of the Internet. Masergy specifically disclaims any warranties, endorsements or representations regarding any merchandise, information, software, products, data, files, or services provided through the Internet.
Data Use Each party may use Connected Account Data in accordance with this Agreement and the consent (if any) each obtains from each Connected Account. This consent includes, as to Stripe, consent it receives via the Connected Account Agreement.
Use of Basement and Service Areas The basement(s) and service areas, if any, as located within the
