Your Signature (Sign exactly as your name appears on the face of this Note) Signature Guarantee*: _________________________ * Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor acceptable to the Trustee).
Employee Signature I certify that I have read this complete agreement and provided the information necessary for the employer to administer the plan and that my salary reductions will not exceed the elective deferral or contribution limits as determined by Applicable Law. I understand my responsibilities as an Employee under this Program, and I request that Employer take the action specified in this agreement. I understand that all rights under the annuity or custodial account established by me under the Program are enforceable solely by my beneficiary, my authorized representative or me.
Witness Signature Witness Address …………………………………………..
Name of Xxxxx(s) The named person's role in the firm, and
Name of Felon(s) The named person's role in the firm, and
Contract Signature If the Original Form of Contract is not returned to the Contract Officer (as identified in Section 4) duly completed, signed and dated on behalf of the Supplier within 30 days of the date of signature on behalf of DFID, DFID will be entitled, at its sole discretion, to declare this Contract void.
Witness Name Address: THE SECRETARY OF STATE FOR EDUCATION Duly Authorised
Name of Company The name of the Company shall be as set forth in the Certificate.
Signature Signature For the participant For the institution
Signature Date PLEASE INITIAL PAGE 2 Please retain a photocopy of this form for your own records. Terms and Conditions on Reverse Side
