ContractDirect Payment Agreement • November 14th, 2024
Directorate of Adults and CommunitiesDirect Payment Agreementwith an Authorised PersonForm DP2 (Updated November 2024) This Agreement should be used if the Direct Payment Recipient has been assessed as lacking capacity to consent to the Direct Payment, and an Authorised Person has requested a Direct Payment on their behalf. A. About this Agreement This Direct Payment Agreement includes the rules about using the Direct Payment. The backpage includes an explanation of some of the words and phrases that have been used. If there is anything that you do not understand, please ask the recipients health, social care, or education worker. This Agreement should be read alongside the Plan. The Plan is the document that includes information about how the Recipient’s Care and Support needs will be met. The Plan also explains how much of the Personal Budget will be paid as a Direct Payment and details the goods and services that you can pay for with the Direct Payment. Your appointment as Authorise
Direct Payment AgreementDirect Payment Agreement • February 26th, 2024
Direct Payment Agreement Adult Direct Payment Agreement (easy-read version) 22/05/2020 Adult Social CareDirect Payment Agreement • June 1st, 2020
This agreement is between Cornwall Council New County Hall Treyew Road TruroTR1 3AY In this agreement we will be named theCouncil. and Name: Contract full name Address:Contract address 1Contract address 2Contract address 3Contract address 4 Contract postcode
ContractDirect Payment Agreement • August 17th, 2023
Directorate of Adults and CommunitiesDirect Payment Agreementwith the Direct Payment RecipientForm DP1(Updated August 2023) This Agreement should only be used if the Direct Payment Recipient is aged 16 or over and has capacity to consent to the Direct Payment. If the Recipient has been assessed as lacking capacity to consent, Form DP2 - Direct Payment Agreement with an Authorised Person should be signed. A. About this Agreement This Direct Payment Agreement includes the rules about using the Direct Payment. The back page includes an explanation of some of the words and phrases that have been used. If there is anything that you do not understand, please ask your health, social care, or education worker. This Agreement should be read alongside the Plan. The Plan is the document that includes information about your care and support needs and how they will be met. The Plan also explains how much of the Personal Budget will be paid as a Direct Payment and details the goods and services that
Direct Payment AgreementDirect Payment Agreement • May 22nd, 2020
Agreement to Participate in Direct Payment scheme Financial Terms and ConditionsDirect Payment Agreement • March 20th, 2018
This Agreement is made between NHS Highland and/or the Highland Council and is in relation to a Supported Person’s agreement to participate in a Direct Payment Scheme. The Agreement requires to be signed by or on behalf of the Supported Person by the Responsible Person. The Responsible Person shall, where the Supported Person is under the age of 16 years, be the Supported Person’s parent or some other person holding parental rights and responsibilities for the Supported Person. Where the Supported Person is over 16 years the Responsible Person shall be the Supported Person except in cases where the Supported Person has been assessed as lacking capacity. In those circumstances the Responsible Person shall be the Supported Person’s properly appointed guardian or attorney, or that guardian’s nominee.
Direct Payment AgreementDirect Payment Agreement • November 21st, 2019
You and/or the Authorised Person will have received, read, and understood, a series of fact sheets during the process of setting up your direct payment giving you a range of information about the Direct Payments Scheme. This agreement is the document...Direct Payment Agreement • December 6th, 2023
✓ We will share your care and support plan with you, and any other person or organisation that you nominate, which will tell you clearly how the direct payment has been worked out and how we have agreed with you that it should be used.
Derbyshire County Council Direct Payments AgreementDirect Payment Agreement • October 15th, 2018
Note: In this document, all references to the Direct Payment Recipient (or ‘I’ or ‘you’ or ‘your’ or ‘my’ or ‘mine’ or ‘their’) may refer to, and include, the Nominee or the Authorised Person or Carer where they have signed the Direct Payment Agreement.
Direct Payment AgreementDirect Payment Agreement • September 20th, 2021
This Direct Payment Agreement (“the Agreement”) sets out the steps that you need to take when you receive your direct payment. Please read it carefully as it is legally binding.
DIRECT PAYMENT AGREEMENT GENERAL TERMSDirect Payment Agreement • March 22nd, 2023
Wrexham County Borough Council (“WCBC”) has carried out an assessment of eligible needs and has agreed to the support described in the recipient’s current Personal Plan (referred to in this document as a “Care and Support Plan”) to be provided through a Direct Payment.
West Hampshire Clinical Commissioning Group Direct Payment AgreementDirect Payment Agreement • October 27th, 2020
This agreement sets out the terms and conditions of receiving on-going direct payments from West Hampshire Clinical Commissioning Group (WHCCG).
Direct Payment AgreementDirect Payment Agreement • February 5th, 2015
The Council has carried out an assessment of your needs / the Child’s needs / Young Person’s needs and has determined that the support services identified in the care and support plan can be suitably be provided via a Direct Payment.
ContractDirect Payment Agreement • November 21st, 2019
Please complete and return this agreement to Z&R to initiate direct payment of your Homeowners Association dues. Please attach or scan a voided check to accompany this form to validate the Routing and Account number. Dues changes will automatically be adjusted, and you will be notified in writing of such an occurrence. When Z&R receives notification of an upcoming sale, your EFT information will be automatically deleted, and any further transactions will cease. Your signature will activate automatic withdrawal of dues from the account indicated in the amount of $
Direct Payment agreement ADULTS June 2024 (V11)Direct Payment Agreement • June 11th, 2024
This agreement is between Somerset Council Adult Social Care County Hall Taunton TA1 4DY (referred to in this agreement as “SC” We, or “us”)
DIRECT PAYMENT AGREEMENTDirect Payment Agreement • May 5th, 2020
Personal Budget Direct Payment AgreementDirect Payment Agreement • April 24th, 2015 • England and Wales
Nominee (you) (Parent, young person, third party to receive the payment. You may nominate a person to act for you in this agreement. By signing this agreement, they agree to support to achieve the outcomes in the support plan and are capable of managing and assisting you with direct payments.)
Agreement between you, Core Arts Brokerage and City & Hackney CCGDirect Payment Agreement • December 4th, 2020
(PHB) directly into a bank account, this is called a Direct Payment. This means you can pay directly for items in your PHB support plan to help your recovery journey.
ContractDirect Payment Agreement • October 12th, 2020 • England
The County Council has carried out an assessment of your needs for community care services and has agreed that the support identified in the attached Support Plan should be provided.
Direct Payment Agreement FormDirect Payment Agreement • January 26th, 2011
ContractDirect Payment Agreement • June 2nd, 2017
Payments are due on the 25th of each month beginning on June 25, 2017. I understand and acknowledge that my account will continue to be drafted on a monthly basis until I properly cancel under the terms of this agreement.
TYPE OF AGREEMENT: CARED FOR PERSONDirect Payment Agreement • May 5th, 2015
The purpose of this document is to regulate the operation of direct payments made by Wiltshire Council to the recipient.
Adult Social Services Direct Payment Agreement (“the Agreement”)Direct Payment Agreement • July 6th, 2015
AGREEMENT FOR DIRECT PAYMENT OF SHAREHOLDER WATER CHARGES BY LESSEEDirect Payment Agreement • January 19th, 2012
CARPINTERIA VALLEY WATER DISTRICT DIRECT PAYMENT AGREEMENTDirect Payment Agreement • January 12th, 2010
After enrollment in the Direct Payment Program you’ll still continue to receive your itemized monthly water bill. The amount of your water bill will be automatically debited from your checking or savings account on the 20th of the month. Of course, you can still call the District office if you ever have questions about your bill.
DIRECT PAYMENT AGREEMENTDirect Payment Agreement • April 7th, 2022
THIS DIRECT PAYMENT AGREEMENT (Agreement) is made and entered into effective as of the date signed below (the “Effective Date”), by and between [Name] (“the Water System”), [Address] and HORNE LLP, a Delaware limited liability partnership, having a place of business at 661 Sunnybrook Road, Suite 100, Ridgeland, MS 39157 (“HORNE”).
Direct Payment AgreementDirect Payment Agreement • July 13th, 2017
The Village of Kohler Water and Sewer Utility is now able to accept ACH payments for your water and sewer utility bill. How does this work? Once you are signed up for direct payment, you will receive a water and sewer utility billing statement in the mail each quarter, then on the due date shown on the statement your utility payment will be automatically withdrawn from your bank account for the amount due. No checks to write, no postage, no late fees. If you are interested, please complete the Direct Payment Agreement Form below and return your completed form along with a voided check to the Village of Kohler Clerk-Treasurer’s Office, 319 Highland Drive, Kohler, WI 53044. If you have any questions about Direct Payment please contact the Clerk-Treasurer’s Office at 920-459-3873.
Books] Directorate Of People Services Direct Payment AgreementDirect Payment Agreement • October 23rd, 2020
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With the Direct Payment Recipient (DP1)Direct Payment Agreement • August 30th, 2019
This Agreement should only be used if the Direct Payment Recipient it is aged 18 or over and has capacity to consent to the Direct Payment. If the recipient has been assessed as lacking capacity to consent, Direct Payment Agreement (DP2) with an Authorised Person should be signed.
5/5/2020 RKing@anaheim.netDirect Payment Agreement • March 17th, 2020 • California
This Agreement consists of this Direct Pay Agreement (“Agreement”), and Attachment 1, which is incorporated herein by this reference. This Agreement is entered into between the California Department of Community Services and Development (CSD), and the City of Anaheim, (“Utility”):
Direct Payment AgreementDirect Payment Agreement • March 14th, 2024
In order to receive a direct payment, you will need to enter into an agreement with Southampton City Council (‘the Council’). This agreement outlines your own responsibilities when using the direct payment as well as the Council’s responsibilities. No payment of money can start without this agreement being signed and received by the Council.
Direct Payment AgreementDirect Payment Agreement • April 7th, 2020
This Agreement is legally binding on both Derby City Council and XXXXX and states what you must do in agreeing to receive a direct payment and what we will do when agreeing to make the payments to you.
ContractDirect Payment Agreement • November 12th, 2018
Please complete and return this agreement to Z&R to initiate direct payment of your Homeowners Association dues. Please attach or scan a voided check to accompany this form to validate the Routing and Account number. Dues changes will automatically be adjusted, and you will be notified in writing of such an occurrence. To stop this transaction from occurring, please put the request in writing (email is accepted). When Z&R receives notification of an upcoming sale, your EFT information will be automatically deleted, and any further transactions will cease. Your signature will activate automatic withdrawal of dues from the account indicated in the amount of
DIRECT PAYMENT AGREEMENT FORMDirect Payment Agreement • December 5th, 2018
ContractDirect Payment Agreement • April 14th, 2011
The personal information collected on this form will be used for the purpose of providing funds though Autism Funding: Age 6–18 Program under the authority of the Supply Act and guided by the Freedom of Information and Protection of Privacy Act. Any questions about the collection, use or disclosure of this information should be directed to the Autism Funding Branch, Toll Free: 1-877-777-3530 or In Greater Victoria: 250-387-3530, PO Box 9776 Stn Prov Govt, Victoria BC V8W 9S5.
