Signature and Certification. Sign in ink, in the space provided. This is your promise to pay. Recheck your Application/Promissory Note to make sure you have correctly completed all items. Family Education Loan (FEL) Alaska Commission on Postsecondary Education P.O. Box 110505 Juneau, Alaska 99811-0505 Customer Service Center Toll Free: (000) 000-0000 In Juneau: (000) 000-0000 TDD: (000) 000-0000 Fax: (000) 000-0000 Application and Master Promissory Note xxxx.xxxxxx.xxx DO NOT COMPLETE: Xxxxxxxx, retain this copy for your records The Alaska Commission on Postsecondary Education (ACPE) services the education loans owned by the Alaska Student Loan Corporation (ASLC).
Signature and Certification. REQUIRED The adult household member who fills out the application must sign below. If Part 4 is completed, the adult signing the form must also list the last four digits of his/her Social Security Number (SSN) or check the box if no SSN. See Privacy Act Statement on the back of this page. If you have listed a case number in Part 2 or are applying on behalf of a xxxxxx child, or have checked the box that your child(ren) will not qualify for Free/Reduced- Price meals, the last four digits of the SSN is not needed. “I certify (promise) that all information on this application is true and that all income is reported. I understand that this information is given in connection with the receipt of Federal funds, and that CACFP officials may verify (check) the information. I am aware that if I purposely give false information, the participant/center may lose meal benefits, and I may be prosecuted under applicable State and Federal laws.” Signature of Adult Today’s Date X Print Name of Adult Signing Social Security Number (SSN) (last four digits) XXX-XX- Check if no SSN Address City/State/Zip Code Daytime Phone OSPI CNS (Rev. 1/19) Page 1 of 2 White Native Hawaiian or Pacific Islander Multi-Racial Black or African American Asian Not Hispanic or Latino We are required to ask for information about your children’s race and ethnicity. This information is important and helps to make sure we are fully serving our community. Responding to this section is optional and does not affect your children’s eligibility for receiving meals during care.
Signature and Certification. All baseline monitoring reports must be signed and certified in accordance with Section 7 of this Division.
Signature and Certification. Sign in ink, in the space provided. This is your promise to pay. Review your Application/Promissory Note to make sure you have correctly completed all items. Alaska Commission on Postsecondary Education P.O. Box 110505 Juneau, Alaska 99811-0505 Customer Service Center Toll Free: (000) 000-0000 In Juneau: (000) 000-0000 TDD: (000) 000-0000 Fax: (000) 000-0000
Signature and Certification. The undersigned certifies to MFA that it has read and understands all of its obligations under the Section 504 requirements. The undersigned acknowledges that this certification will be relied upon by MFA in its review and approval of proposal for funding and any misrepresentation of information or failure to comply with any conditions proposed in this certification could result in penalties, including the disbarment of applicant from participation in MFA administered programs for a period of time. Name of Funded Program: Organization Name: Agency Director Signature Date MFA Program Manager Signature Date Section 504 Checklist Used for monitoring purposes of compliance with Section 504 of the Rehabilitation Act of 1973. Recipient Name: Date Prepared: Address: Telephone:
Signature and Certification. I certify that I have read and accept this Daily Guest Apartment Rental Contract including all of the terms and conditions of occupancy. Guest Signature: Date:
Signature and Certification. This Annual Audit Compliance Report may only be signed by a person(s) with legal authority to sign it. The ways in which the Annual Audit Compliance Report must be signed and certified and the people who may sign the statement, are set out below. Please tick the box next to the category that describes how this Annual Audit Compliance Report is being signed. If you are uncertain about who is entitled to sign or which category to tick, please contact the licensing officer for your premises. If the licence holder is The Annual Audit Compliance Report must be signed and certified: an individual □□ by the individual licence holder, or by a person approved in writing by the Chief Executive Officer of the Department of Environment Regulation to sign on the licensee's behalf. A firm or other unincorporated company □ □ by the principal executive officer of the licensee; or by a person with authority to sign on the licensee's behalf who is approved in writing by the Chief Executive Officer of the Department of Environment Regulation. □ by affixing the common seal of the licensee in accordance with the Corporations Act 2001; or □ by two directors of the licensee; or □ by a director and a company secretary of the licensee, or A corporation □ if the licensee is a proprietary company that has a sole director who is also the sole company secretary – by that director, or □ by the principal executive officer of the licensee; or □ by a person with authority to sign on the licensee's behalf who is approved in writing by the Chief Executive Officer of the Department of Environment Regulation. □ by the principal executive officer of the licensee; or A public authority (other than a local government) □ by a person with authority to sign on the licensee's behalf who is approved in writing by the Chief Executive Officer of the Department of Environment Regulation. □ by the chief executive officer of the licensee; or
Signature and Certification. ✔ I certify that I have established an IRA with the TCW Funds, Inc. of which U.S. Bank, NA, is the Custodian. I agree to contact my present Custodian from whom I am transferring to determine if specific documentation or a signature guarantee is required. I understand that I am responsible for determining my eligibility for all transfers or direct rollovers. I agree to hold the Custodian harmless against any and all situations arising from an ineligible transfer or direct rollover. I acknowledge that the Custodian or its agent cannot provide legal advice and I agree to consult with my own tax professional for advice. I authorize U.S. Bancorp Fund Services, LLC, to act on my behalf in contacting the current custodian or plan administrator to facilitate the transfer of assets. X Signature of Owner (or Guardian if IRA owner is a minor) Date (MM/DD/YYYY) Signature Guarantee* (for transfers from another Custodian) IMPORTANT: Please contact your current Custodian to determine if a signature guarantee* is required. * A signature guarantee may be obtained from any eligible guarantor institution, as defined by the Securities and Exchange Commission. These institutions include banks, saving associations, credit unions, and brokerage firms. The words “SIGNATURE GUARANTEED” must be stamped or typed near your signature. The guarantee must appear with the printed name, title, and signature of an officer and the name of the guarantor institution. Please note that a Notary Public Seal or Stamp is not acceptable.
Signature and Certification. SCSC has the right to determine when provisions of this agreement are violated and to determine the appropriate course of action. If any section or subsection of this contract is ruled to be illegal or invalid, this will not affect the validity or enforceability of the remaining provisions of the contract. The Renter agrees to indemnify and hold harmless SCSC and its personnel from any and all liability, loss, or damage the Renter may suffer as a result from the Renter’s use of the campgrounds, except to the extent allowed by law. Renter agrees that any dispute concerning, relating, arising out of or referring to the subject matter of this contract shall be resolved exclusively by binding arbitration in Tulare County, California according to the then existing commercial rules of the American Arbitration Association and the substantive laws of CA. In addition, the Renter may wish to provide SCSC a Certificate of Insurance naming SCSC as an Additional Insured, otherwise the renter will be held personally financially responsible for items damaged by renters. I certify that I have read and accept this Rental Contract including all of the terms and conditions of occupancy. Signature Date Sierra Christian Service Camp Executive Director Xxxxx Xxxxxx. Signature: Date Sierra Christian Service Camp: 00000 Xxx Xxxxx Xxxx – Xxxxx, XX 00000 Phone (000)000-0000 Email: xxxxxxx@xxxxxxxxxxxxxxxxxxxxxxxxxx.xxx Web: xxx.xxxxxxxxxxxxxxxxxxxxxxxxxx.xxx Executive Director: Xxxxx Xxxxxx
Signature and Certification. All baseline monitoring reports must be signed and certified in accordance with §18-326 of this Part. [A.O.] (Ord. 422, 10/12/1994; as amended by A.O.
