Authorization Agreement Sample Contracts

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CHAPTER I
Authorization Agreement • June 30th, 2004 • Telesp Cellular Holding Co /Adr/ • Telephone communications (no radiotelephone)
Agreement & authorization to act as direct representative V2.6
Authorization Agreement • March 28th, 2024

The Principal authorizes and places orders with the Freight Forwarding Company, in conformity with Article 18, and further, of the Union Customs Code (Regulation no. 952/2013/EU), against the agreed remuneration, to make the declarations prescribed in the customs legislation -and where possible in other legislation- ‘in the name and for the account of’ the Principal. This authorization and the order apply to the shipment of goods presented by/on behalf of the Principal, for which the Principal has provided the Freight Forwarding Company with the records/information. This authorization and the order comprise all acts and communications up to and including the completion of the verification of the declaration and those in connection with the issue of the communication of the amount of the customs debt.

DILTS STRATEGY GROUP AUTHORIZATION AGREEMENT
Authorization Agreement • April 18th, 2022

This authorization agreement relates to the use of the Success Factor Modeling manual(s) and PowerPoint slides as specified in APPENDIX A (“LEARNING MATERIALS”).

Authorization Agreement:
Authorization Agreement • November 4th, 2019
Contract
Authorization Agreement • March 13th, 2017

This authorization agreement is made in conformance with Chapter 34 of the Texas Family Code concerning the following Child:

AUTHORIZATION AGREEMENT- AUTOMATIC WITHDRAWAL OF FUNDS
Authorization Agreement • June 6th, 2024

Please take my donation from my (check one): Checking Account Savings Account Business Checking Account Date of first donation: / / Routing # Valid routing # must start with 0, 1, 2 or 3 Account # Frequency of donation (check only one) Monthly on the third Monthly on the 18th Donation Designation: Amount: $

ENTERPRISE AUTHORIZATION AGREEMENT ELECTRONIC SETTLEMENT / PAPER DRAFT PO BOX 4324‌
Authorization Agreement • October 21st, 2020 • Texas

This Authorization Agreement is intended to allow Enterprise to make withdrawals or deposits as above said from or to CUSTOMER’s account at frequent intervals and for varying amounts for rents, service charges, credit card transactions, product purchases and other charges, or for reimbursements or adjustments, payable to or by Enterprise. This authority is to remain in full force and effect until Enterprise and DEPOSITORY have received written notification from CUSTOMER of its termination or of any change of bank account number or depository bank in such time and in such manner as to afford Enterprise and DEPOSITORY a reasonable opportunity to act on it. The General Terms and Conditions attached hereto are incorporated herein by reference

AUTHORIZATION AGREEMENT
Authorization Agreement • July 25th, 2008 • Legend Media, Inc. • Services-miscellaneous business services
AGREEMENT
Authorization Agreement • October 25th, 2023

Deduct ongoing monthly premium payments from my designated checking or savings account. If the withdrawal date falls on a non-business day or a holiday, the premium payment will be deducted from my account on the next business day. (Please note that coverage cannot be issued until the first month of premium has been received in our office, unless you have authorized BCBSMT to deduct the initial payment upon receipt of your application).

Take these simple steps for hassle-free monthly premium payments:
Authorization Agreement • August 8th, 2011
AUTHORIZATION AGREEMENT
Authorization Agreement • December 3rd, 2008 • Legend Media, Inc. • Services-miscellaneous business services
T S R T C
Authorization Agreement • May 16th, 2018
Single Institutional Review Board (sIRB) of Record for Cooperative Research
Authorization Agreement • January 26th, 2021

Authorization Agreement – Also called the Reliance Agreement, which documents respective authorities, roles, responsibilities, and communication between an organization providing the ethical review and a participating organization relying on a reviewing IRB.

Contract
Authorization Agreement • January 31st, 2018

This authorization agreement is made in conformance with Chapter 34 of the Texas Family Code concerning the following Child:

Authorization Agreement – Indirect (US)
Authorization Agreement • November 5th, 2021 • Delaware

This authorization agreement is between SMART Technologies Corporation (“SMART”) and the entity accepting this agreement (“Reseller”) and is effective as of the authorization date noted in your authorization approval letter from SMART (the “Effective Date”).

AUTHORIZATION AGREEMENT
Authorization Agreement • December 15th, 2020
Agreement & Authorization to act as direct representative
Authorization Agreement • March 15th, 2024

The Principal / the party directly representedCompany Full Name ……….Address ………. The Freight Forwarding CompanyCompany Name Address / Direct RepresentativecenturisticsBijlmermeerstraat 30 Zip Code | Place ………. | ………. Zip Code & Place 2131 HC Hoofddorp EU Country ………. EU Country The Netherlands CoC (KvK) Number ……….VAT ID Number | EORI Number ………. | ………. CoC (KvK) NumberVAT ID Number | EORI Number 84066660NL863083614B01 | NL863083614 Contact Name | Passport Number ………. | ………. Email | Phone info@centurstics.com | +31 20 3086386

Authorization agreement for the use of the Online Web Library
Authorization Agreement • May 25th, 2011

The Facilities Information Services Library has set up this web site “OWL” as a means of providing a research environment for you and your colleagues. By using the Facilities Information Services Library web site “OWL”, you agree to be bound by the terms of this agreement. You must accept the general provisions of this agreement before you may gain access to the system. Specifically, you agree that:

Authorization Agreement – Instructions and Enrollment Form
Authorization Agreement • March 20th, 2021

Submission of the Full Electronic Solution form allows Delta Dental of New Jersey and Connecticut, Delta Dental member companies and their affiliates to support National EFT and National Electronic EOBs. Please note that changes or termination to your EFT will result in termination of ERA. General Instructions National ERA Enrollment is offered to offices enrolled in National EFT. National EFT enrolls your office in Direct Deposit across all Delta Dental member companies. Enrollment in National ERA allows you to obtain your claim detail for all Delta Dentals in the same format, same location (www.deltadental.com) and with the same username and password as www.deltadentalnj.com. Contact Information Delta Dental of New Jersey, Inc. Professional Services Department Phone 800-494-4137Fax 973-285-4192ddsrelations@deltadentalnj.com Enrollment in EFT/ERA Please allow up to thirty days (30) to complete EFT/ERA newand changes to enrollment.

Take these simple steps for easy monthly premium payments:
Authorization Agreement • February 21st, 2012

debit entries, and I request and authorize the Financial Institution named below to accept and honor the same to my account. This authorization will remain in effect until I notify BCBSIL or the Financial Institution in writing to terminate and BCBSIL or the Financial Institution has a reasonable time to act on the termination.

Please enter your details in the fields below. Print and sign the form and send to:
Authorization Agreement • March 23rd, 2015

Registered Holder(For joint holders - complete & sign individual forms, cross referencing the other) Registered Address Unit Holder LevelPlease insert the account name to be covered by this agreement.Please note this coverall will not be applied to any account numbers not quoted. A separate form will need to be completed for additional account numbers. Client LevelPlease insert the account name to be covered by this agreement.This will cover all current and future designations for this client. Instructing FirmPlease insert the name of any firm which has been appointed as agent to place orders on behalf of the Registered Holder. Otherwise the term “Instructing Firm” as used in this form shall be understood as being the Registered Holder.

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AGREEMENT TO AUTHORIZE COMMUNICATION OF ELECTRIC ACCOUNT INFORMATION BETWEEN CAPE HATTERAS ELECTRIC COOPERATIVE AND PROPERTY MANAGEMENT COMPANY
Authorization Agreement • November 5th, 2020

Realty Company. By signing this form, I am authorizing communications regarding the electric service account for this property between Cape Hatteras Electric Cooperative staff and the above referenced property management company.

Authorization Agreement for Flex Chek
Authorization Agreement • September 11th, 2021
Authorization Agreement
Authorization Agreement • May 10th, 2022

PLEASE COMPL ETE T HE INFORMATION BELOW Legal Entity Name Primary Contact Telephone Number Legal Address Billing Address (if different) City, State, Zip Billing City, State, Zip Email Address Language Preference* ☐ English ☐ Spanish

Contract
Authorization Agreement • January 12th, 2022

Newly contracted agents: Return this authorization form to documentcenter@ ohionational.com with your Enrollment Form.

AGREEMENT
Authorization Agreement • October 25th, 2023

Deduct ongoing monthly premium payments from my designated checking or savings account. If the withdrawal date falls on a non-business day or a holiday, the premium payment will be deducted from my account on the next business day. The initial draft will include any past due premiums required to bring my policy current.

Authorization Agreement
Authorization Agreement • June 15th, 2006 • Hurray! Holding Co., Ltd. • Communications services, nec

I, Shang Aiqin, a citizen of the People’s Republic of China (the “PRC”), the ID Card Number 110106197208012424, hereby irrevocably assign to Mr. Wang Qindai the following powers and rights during the term of this Letter of Undertaking:

AUTHORIZATION AGREEMENT FOR ENROLLMENT IN THE SENIOR PRIVILEGE PROGRAM
Authorization Agreement • January 6th, 2024

Senior Privileges allow students the opportunity to earn the use of available high school facilities for worthwhile purposes during an unassigned free period. These purposes include: pursuit of academic assignments in the LMC, front courtyard, and cafeteria during non lunch periods. Senior Privileges for an academic year may be granted at the start of the marking period or can be revoked at any time for reasons due to academic needs, behavioral circumstances or upon parent request. It is the student’s responsibility to submit a completed application and waiver for approval to the Dean of Students.

Contract
Authorization Agreement • February 3rd, 2024

Terms of Agreement: I hereby authorize Miracle Family Speech Therapy (MFST) to submit a claim to my insurance carrier for all covered services rendered by the therapist and authorize and direct my insurance carrier or its intermediaries to issue payment checks directly to the therapist rendering the covered service. I will be responsible for those charges deemed not covered by said insurance carrier so long as such insurance has not been deemed such services to be medically inappropriate or unnecessary. I also understand that if my insurance company is not a contracted carrier, I am responsible for the full fee charged by my therapist regardless of what my insurance pays. I authorize MFST to furnish complete information to my insurance carrier and its intermediaries regarding the services rendered. I permit a copy of this authorization to be used in the place of the original. I consent to assign all payments for these services to this practice. I understand that I am responsible for al

Institutional Review Board (IRB)/Independent Ethics Committee (IEC) Authorization Agreement
Authorization Agreement • September 16th, 2022

The Officials signing below agree that _______________________________________________may rely on the designated IRB for review and continuing oversight of its human subjects research described below:

Employer Name:
Authorization Agreement • October 8th, 2018

Note: Do not cancel any current coverage you may have until your Application is approved and your new plan is effective. To use ACH for payment of initial premium payment please select ONE-TIME BANK DRAFT below, complete the balance of the form in its entirety, and submit to your Broker or Producer for processing.

Annex I to
Authorization Agreement • June 27th, 2006

………………., hereafter referred to as RO, governing the authorization of statutory survey and certification services of ships registered in the Netherlands, flying its flag, classed by RO and to which the international conventions are applicable.

Institutional Review Board (IRB)/Independent Ethics Committee (IEC) Authorization Agreement
Authorization Agreement • September 16th, 2022

The Officials signing below agree that the University of San Diego may rely on the designated IRB for review and continuing oversight of its human subjects research described below:

AUTHORIZATION AGREEMENT FOR MONTHLY CHECKING ACCOUNT PAYMENTS
Authorization Agreement • April 6th, 2017
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