Disability AGREEMENT FORMDisability Agreement • October 30th, 2020
The student declares to have deposited a copy of the disability certificate (issued by the competent LHA and currently valid) with the Secretariat and sent it to the Desk.
Disability AgreementDisability Agreement • August 29th, 2013
Instructions: This form must be submitted whenever you file for disability as an advancement of Worker’s Compensation. Photocopies cannot be accepted. All blanks must be completed. Alteration of this form or failure to fill in all blanks may result in the form being returned to you. This will cause a delay in the processing of your claim. Name State of Ohio User ID On the day of , , at Ohio, in the County of , this agreement between the State of Ohio, the Department of Administrative Services, Benefits Administration Services, Disability section hereafter referred to as DAS, and , Employee, was executed under the following terms and conditions: Employee has filed an application for disability leave benefits for a disability resulting from an injury or illness received on , . Employee has been denied an initial claim for Workers’ Compensation Lost Time Wages by the Bureau of Workers’ Compensation and is appealing the BWC order denying lost time benefits. DAS agrees to pay a reimbursabl
AMENDMENT NO. 1 TO DISABILITY AGREEMENTDisability Agreement • March 2nd, 2009 • GFI Group Inc. • Security & commodity brokers, dealers, exchanges & services • New York
This AMENDMENT NO. 1 (this “Amendment”) to that certain Disability Agreement, dated as of December 30, 2004 (the “Agreement”), by and between GFI Group Inc., a Delaware corporation (the “Company”), and Michael A. Gooch (the “Executive”), is made on December 31, 2008 (the “Amendment Effective Date”).
DISABILITY AGREEMENTDisability Agreement • January 24th, 2005 • GFI Group Inc. • Security & commodity brokers, dealers, exchanges & services • New York
AGREEMENT (the "Agreement") between GFI Group Inc., a Delaware corporation (the "Company") and Michael A. Gooch (the "Executive"), dated as of this 30th day of December 2004 (the "Effective Date").
