Birth Date definition

Birth Date means the medication recipient's birth date.

Birth Date. Email: City: Alt. Phone:

Birth Date. Gender: Student: Yes No 17 or under Yes No Emergency Contact: Home phone: Cell Phone: Name of Insurance Company: Insurance Plan Name: Group Number (if a group policy): Participant Account Number: Allergies: Medications: In exchange for being allowed to participate in activities at Faith Presbyterian Church (FPC), a Washington nonprofit corporation, I submit this Release, Waiver, and Indemnification Agreement (Agreement) and agree to the following:

Examples of Birth Date in a sentence

• Social Security Number Birth Date (MM-DD-YYYY) Gender (M or F) US Citizen ( Y or N) US Veteran or Spouse of Veteran (Y or N)Last Name First Name MI Previous Last Name (Maiden)(If your name has changed since your last application, proof of name change must be attached e.g. photocopy of marriage certificate, etc.)Street Address City State Zip CodePrimary Phone Secondary Phone E-Mail If you answer yes to any question below, SUBMIT a narrative with your application.

• Social Security Number Birth Date (MM-DD-YYYY) Gender (M or F) US Citizen ( Y or N) US Veteran or Spouse of Veteran (Y or N) Last Name First Name MI Previous Last Name (Maiden)(If your name has changed since your last application, proof of name change must be attached e.g. photocopy of marriage certificate, etc.)Street Address City State Zip Code Primary Phone Secondary Phone E-Mail If you answer yes to any question below, SUBMIT a narrative with your application.

• Place of Birth: Date of Birth: Sex:Male Female  Check this box if the information requested below would be the same as in subsection 2a and skip to the next question.

• First Name MI Last Birth Date (mm/dd/yy) Office Title Employer (if not employed by entity) Home Address  This person replaced former CEO on date Chief Financial Officer (CFO) or equivalent officer  This position does not existThe highest ranking financial officer, such as the Treasurer, Comptroller, Financial Director or VP for Finance.

• Your Age on Your Birth Date This Year Length of Time Deposit (If applicable) The charts below give projections of the value of your IRA by showing the amount available at the end of each year.

• Example: Patient Module includes Patient Name, Patient ID, Patient Birth Date, and Patient Sex.

• Non-Repairable Products– If We, in Our sole discretion, determine that Your Product is not repairable, We will provide a new, rebuilt, or refurbished product of equal or similar features and functionality (not necessarily at the same retail purchase price as the originally Product) or, at Our option, if a similar product is not available, We will either issue a Gift Card from THD or provide a refund up to the replacement price of the Product.

• Benefits: Relationship to Insured: Self Spouse Child Other Insured Birth Date: Ins.

• In the event that there is no living primary Beneficiary at my death, I hereby designate the following person or persons as contingent Beneficiaries of my Account: Name: Name: Social Security Number: Social Security Number: Address: Address: Date of Birth: Date of Birth: Relationship to Participant: Relationship to Participant: Percentage: Percentage: The total of the percentages cannot exceed 100%.

• Name: Name: Social Security Number: Social Security Number: Address: Address: Date of Birth: Date of Birth: Relationship to Participant: Relationship to Participant: Percentage: Percentage: The total of the percentages cannot exceed 100%.

More Definitions of Birth Date

Birth Date. Age: Home School: Grade:

Birth Date. Soc. Sec. No.:___________________________ Union Affiliations:______________________ EXHIBIT A PRODUCER DECLARATION I, the undersigned, declare that I have read and understand those relevant portions of the agreement between Wall Street Records LLC ("Wall Street") c/o A&M Records, Inc., Worldwide Plaza, 000 0xx Xxxxxx, Xxx Xxxx, Xxx Xxxx, 00000 and Xxxxxxx Xxxxxxx Xxxxx, Xx. (professionally known as "Xxxxxx" and referred to below as "Artist") dated as of March 13, 1998 ("Artist Agreement") that pertain to my record production endeavors. I hereby certify that I have produced or will have produced certain master recordings embodying Artists featured performance ("Masters") pursuant to an agreement between Artist and me ("Producer Agreement") which provides for valuable consideration to be paid to me. As part of my material obligations pursuant to the Producer Agreement and for the express and direct benefit of Wall Street, I hereby:

Birth Date. Age: SSN: Occupation: Employer: Employer’s Address: Years There: City: State: Zip: Name of Spouse: Birth Date: Age: SSN: Occupation: Employer: Employer’s Address: Years There: City: State: Zip: