USE ONLY AGREEMENT LOCATOR NUMBER: Check the appropriate boxes: A NOTICE OF FEDERAL TAX LIEN (Check one box below.) RSI “1” no further review AI “0” Not a PPIA HAS ALREADY BEEN FILED RSI “5” PPIA IMF 2 year review AI “1” Field Asset PPIA WILL BE FILED IMMEDIATELY RSI “6” PPIA BMF 2 year review AI “2” All other PPIAs WILL BE FILED WHEN TAX IS ASSESSED Agreement Review Cycle: Earliest CSED: MAY BE FILED IF THIS AGREEMENT DEFAULTS Check box if pre-assessed modules included Originator’s ID #: Originator Code: Name: Title: INSTRUCTIONS TO TAXPAYER If not already completed by an IRS employee, please fill in the information in the spaces provided on the front of this form for: • Your name (include spouse’s name if a joint return) and current address; • Your social security number and/or employer identification number (whichever applies to your tax liability); • Your home and work, cell or business telephone numbers; • The complete name, address and phone number of your employer and your financial institution; • The amount you can pay now as a partial payment; • The amount you can pay each month (or the amount determined by IRS personnel); and • The date you prefer to make this payment (This must be the same day for each month, from the 1st to the 28th). We must receive your payment by this date. If you elect the direct debit option, this is the day you want your payment electronically withdrawn from your financial institution account. Review the terms of this agreement. When you’ve completed this agreement form, please sign and date it. Then, return Part 1 to IRS at the address on the letter that came with it or the address shown in the “For assistance” box on the front of the form. Terms of this agreement By completing and submitting this agreement, you (the taxpayer) agree to the following terms: • This agreement will remain in effect until your liabilities (including penalties and interest) are paid in full, the statutory period for collection has expired, or the agreement is terminated. • You will make each payment so that we (IRS) receive it by the monthly due date stated on the front of this form. If you cannot make a
OFFICE USE ONLY Unit Size Requested Unit Number Targeted Move-In Date Date Received Time Received _R__i_v_e__r_w__o__o_d___A__p__a_r_t_m__e__n__t_s___________________ _9__0_0___W___e_s__t_P__a__r_k__S__t_r_e__e_t_____________________ _C__a__n__n_o__n__F__a__ll_s__,_M___N___5_5__0__0_9_________________ _P__h__:_(_5__0__7_)__2__8_9__-_1__8_9__5________________________ APPLICATION FOR OCCUPANCY Incomplete applications will be returned APPLICANT INFORMATION Applicant Name (Head of Household): First Middle Last Address: Street Address City State Zip Social Security Number: Date of Birth: [ ] Male [ ] Female [ ] Decline Applicant Phone #: Applicant Email: Alternate Phone #: Alternate Email: Emergency Contact: Name (Someone outside your household) Phone Email 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 The following questions pertain to yourself and every member of your household who will occupy the unit. Check either Yes or No in response to each question. All questions must be answered; for those questions that do not apply, you are required to indicate so by answering “not applicable” or “n/a”.
Access to and Use of Content Customer has the right to access and use applicable Content subject to the terms of applicable Order Forms, this Agreement and the Documentation.
Misuse of Internet-based Services You may not use these services in any way that could harm them or impair anyone else’s use of them. You may not use the services to try to gain unauthorized access to any service, data, account or network by any means.
Internet Use 7.1. Customer is prohibited from posting or transmitting unlawful material on or via the Internet or the World Wide Web.
INTERNET-BASED SERVICES Microsoft provides Internet-based services with the software. It may change or cancel them at any time.
For Office Use Only Ref No ) Print Name …………………………………………….......... Customer No……………………………..................... Representing………………………………….…………....... Transferor Signature……………………………......... Position in organisation: Representing Hull City Council Owner Partner Other …………......................... Date................................................................................... Date …………………………….................................. Please complete sections A, B, C & sign section F and return this form to Trade Waste Team, Hull City Council, Staveley House, Stockholm Road, HULL HU7 0XW marked F.A.O. Commercial Waste Officer. A copy will be returned to you by email or post for your records after verification. It is a legal requirement to keep this transfer note for at least 2 years after the final collection. P.T.O.
Internet Disclaimer For any Service(s) described in the Agreement utilizing the Internet, Bank does not and cannot control the flow of data to or from Bank's network and other portions of the Internet. Such flow depends in large part on the performance of Internet Services provided or controlled by third parties. Actions or inactions of such third parties can impair or disrupt your connections to the Internet (or portions thereof). Bank cannot guarantee that such events will not occur. Accordingly, Bank disclaims any and all liability resulting from or related to such events and in no event shall Bank be liable for any damages (whether in contract or in tort) that are attributable to the public Internet infrastructure, your ability to connect to the Internet, or Bank's ability to connect to the Internet on your behalf.
