Remaining fees. In consideration for services rendered to AP, AP agrees to pay to Xxxx the balance of the following fees: U.S. Processing $ Overseas Program $ Korea Travel Fee $ Post-placement Services $ AP Initials Date Page 7 -- Placement Agreement AP Initials Date Date Adopting Parent Date Adopting Parent State of ) County of ) [Name/names of AP] personally appeared before me, a Notary Public in and for said state, on this day of , 20_ . Such person(s) is/are personally known to me, or proved on the basis of satisfactory evidence, to be the person(s) whose name(s) is/are subscribed to on the foregoing instrument, and such person(s) acknowledged to me that the foregoing instrument is his/her/their voluntary act and deed, executed in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the foregoing instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature of Notary Public Notary Public for: My Commission Expires: XXXX INTERNATIONAL CHILDREN'S SERVICES Date By: Title:
Remaining fees. In consideration for services rendered to AP, AP agrees to pay to Xxxx the balance of the following fees: U.S. Processing $ Overseas Program $ Korea Travel Fee $ Post-placement Services $ AP Initials Date AP Initials Date Date Adopting Parent Date Adopting Parent State of ) County of ) [Name/names of AP] personally appeared before me, a Notary Public in and for said state, on this day of , 20_ . Such person(s) is/are personally known to me, or proved on the basis of satisfactory evidence, to be the person(s) whose name(s) is/are subscribed to on the foregoing instrument, and such person(s) acknowledged to me that the foregoing instrument is his/her/their voluntary act and deed, executed in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the foregoing instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature of Notary Public Notary Public for: My Commission Expires: XXXX INTERNATIONAL CHILDREN'S SERVICES Date By: Title: This is a sample placement agreement for your reference. Please do not sign or turn in with your application. PLACEMENT AGREEMENT (Non-Finalized Countries SAMPLE) This agreement is entered into by and among Xxxx International Children's Services, Inc. ("Xxxx"), and the following named undersigned prospective Adopting Parent(s) ("AP"). Xxxx and AP are collectively referred to herein as "the parties."
Remaining fees. In consideration for services rendered to AP, AP agrees to pay to Xxxx the balance of the fees outlined in the attached invoice. Date Adopting Mother Date Adopting Father AP Initials Date AP Initials Date XXXX INTERNATIONAL CHILDREN'S SERVICES Date By: Xxxx Worker Director of Services, Country Program CLIENT COMPLAINT PROCEDURE
