Witness Statement. Before leaving the doctor’s office, obtain the Physician’s Release/Work Status and the Job Analysis/Work Recommendations Report from the clinic/hospital doctor after each doctor’s visit via email or fax to Xxxxxxxx XxXxxxx at 000-000-0000.
Witness Statement. Copy of policy report(in case of legal case)
Witness Statement. I hereby swear that on the 13th day of June in the year 2003 before me, the undersigned, personally appeared Xxxxxxx Xxxxx, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the person on behalf of which the individual acted, executed the instrument. Witness my hand this l3th day of June, 2003. /s/ Xxxxxxx Xxxxxx-Xxxxxxxx Xxxxxxx Xxxxxx-Xxxxxxxx Statutory Mortgage Deeds means, collectively, the following statutory mortgages:
Witness Statement. I hereby swear that on the 13th day of June in the year 2003 before me, the undersigned, personally appeared Xxxxxxx Xxxxx, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the person on behalf of which the individual acted, executed the instrument. Witness my hand this l3th day of June, 2003. Xxxxxxx Xxxxxx-Xxxxxxxx COUNTY OF NEW YORK ) ) ss STATE OF NEW YORK ) On the 13th day of June in the year 2003 before me, the undersigned, personally appeared Xxxxxx Xxxxxxx, Xxxxxx Xxxxx Xxxxxxxxxx, Moms Seton, and Xxxxx Xxxxxx, personally known to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in their capacities, and that by their signatures on the instrument, the person on behalf of which the individuals acted, executed the instrument. Witness my hand and notarial seal this 13th day of June, 2003.
Witness Statement. Note: This section is completed by the persons witnessing the declarations of the appointer and person appointed as the co-decision-maker under the co-decision-making agreement. At least one of the witnesses must not be an immediate family member of the appointer or co-decision-maker.
Witness Statement. The witness cannot be the partner involved in the treatment
Witness Statement. Note: This section is completed by a specified person, including: a registered medical practitioner, Garda, Commissioner for Oaths, member of clergy or minister of any religious denomination, lawyer, elected public representative, accountant, dentist, pharmacist or a specified healthcare professional. This person must witness the declarations of the appointer and person(s) appointed as the decision-making assistant(s) under the decision- making assistance agreement.
Witness Statement. 12 Copy of policy report(in case of legal case) Copy of the court award- Notice from the Third party claiming the amount Depending upon the peculiarity of the case, additional documents/information’s will be asked for Covering letter detailing circumstances Cancelled cheque of the insured / nominee Any other documents as required while processing the claim
Witness Statement. DATE: NAME: TITLE: TEMPORARY ADDRESS: PHONE NO: PERMANENT ADDRESS: PHONE NO: LOCATION AT TIME OF ACCIDENT: DESCRIBE, TO THE BEST OF YOUR KNOWLEDGE, HOW THE ACCIDENT HAPPENED: Exhibit 7 — Notice of Safety Non-Compliance To: , Site Representative for Your company has been found to be in non-compliance with one or more Federal, State, Company or JWA/Construction Management’s safety requirements as specified below. This safety non-compliance must be corrected immediately for your company to meet the requirements of your subcontract. Item # Item of Non-compliance Applicable Safety Requirement Item # Item of Non-compliance Applicable Safety Requirement Item # Item of Non-compliance Applicable Safety Requirement Issued By: Signature of Project Manager or Site Manager Date Received By: Signature of Representative Receiving Notice Date Contractor’s Response(s): cc: Area Company Operations Manager Corporate Health & Safety Representative
Witness Statement. Employment status
