Examples of Alternate Agent in a sentence
Name: Relation: Home Phone: Work Phone: Address: Mobile Phone: Other Phone: Alternate Agent: If the person named above is unable or unwilling to make health care decisions for me, I appoint as alternate the following person to make health care decisions for me.
No Alternate Agent shall be liable for any act or omission of the initial Agent.
Fold on the dotted line to create a double sided card EMERGENCY INSTRUCTIONSAgent: Phone Evening: Cell: Alternate Agent: Phone: Evening: Cell: Rabbi: Phone: Evening: Cell Organization Phone: Agudath Israel of America, in partnership with the New York Legal Assistance Group (NYLAG) would like to encourage you to register your Halachic Medical Directive for free with the U.S. Living Will Registry®.
The Medical Monitor for this study is: Xxxxxxx Xxxxxx, MD Title: Associate Medical Director, Lupin Inc.
If my agent is unable or unwilling to act for me, then I designate the Alternate Agent designated above to serve as my agent as authorized in this document.
In such a situation, an HS observation on either point can hold information on precipitation rates at both locations.
The Designation of Authority Form is submitted with each new disaster or emergency declaration to provide the authority for the Sub-Recipient’s Primary Agent and Alternate Agent to access the XxxxxxxXX.xxx system in order to enter notes, review notes and documents, and submit the documentation necessary to work the new event.
Second Alternate Agent 8 Name: _ 9 Address: _ 10 Phone 11 The original of this document is kept at: 12 _ 13 _ 14 _ 15 16 copies: 17 18 The following individuals or institutions have signed Name: _ Address: _ 19 _ 20 Name: _ 21 Address: _ 22 _ 23 DURATION.
I,MASSACHUSETTS HEALTH CARE PROXY (Principal -- PRINT your name)YO U R B I R T H D AT E / / , residing at (Street) (City or Town) (State)appoint as my Health Care Agent: (Name of person you choose as Agent)of (Street) (City/town) (State) (Phone)( OPTIONAL: If my Agent is unwilling or unable to serve, then I appoint as my Alternate Agent:, of(Name of person you choose as Alternate Agent).)(Street) (City/town) (State) (Phone)2.
Ethel Deras Enamorado, Attorney General of the Republic, as agent, and Mr. Ricardo Rodríguez, Deputy Attorney General of the Republic, as Alternate Agent.