Birth Date definition

Birth Date means the medication recipient's birth date.

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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

• 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.

• 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%.

• The following information will be recorded in the log: Subject Name; Subject Date of Birth; Date and Time of the dissemination; Name of the individual to whom the information was provided; Name of the agency for which the requestor works; Contact information for the requestor; and The specific reason for the request.

• Name and Address Birth Date Social Security #* Relationship Beneficiary Type* Share %*  Primary  Contingent  Per Stirpes %  Primary  Contingent  Per Stirpes %  Primary  Contingent  Per Stirpes %  Primary  Contingent  Per Stirpes % If I indicate per stirpes, HTS will require the Authorized Party designated herein to assist HTS with the identity of the per stirpes beneficiary(ies) prior to distributing my account assets.

• First Name: MI: Last: Office Title: Employer (if not employed by entity): Birth Date (mm/dd/yy): Home Phone #: Home Address: This person replaced former CFO: on date: This position does not exist The highest ranking operational officer, such as the Chief Planning Officer, Director of Operations or VP for Operations.

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

• Participant Name Employer Name Participant Mailing Address, City, State, Zip Code Phone Number Date of Birth Date of Hire Participant Email Address Social Security Number (required) The Salary Reduction Agreement (SRA) is to be used to establish, change, or cancel salary reduction withheld from your paycheck and contributed to the 403(b) and/or 457(b) plan on your behalf.

• Participant Name Employer Name Participant Mailing Address, City, State, Zip Code Phone Number Date of Birth Date of Hire Email Address Social Security Number (required) The Salary Reduction Agreement (SRA) is utilized to establish, change, or cancel salary reduction withheld from your paycheck and contributed to the 403(b) plan on your behalf.

• Full Name Residence Telephone (Area Code Number) Business Telephone (Area Code Number) Residence or Principal Address (Street/City/State/Zip Code) Birth Date Mailing Address (if other than residence) Citizenship (U.S./Other) Marital Status Social Security/Taxpayer I.D. Number Spouse’s Full Name E-mail Address Spouse’s Social Security Number Facsimile Number (Area Code/Number) ACCREDITED INVESTOR.

More Definitions of Birth Date

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, ▇▇▇ ▇▇▇ ▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇, ▇▇▇ ▇▇▇▇, ▇▇▇▇▇ and ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇. (professionally known as "▇▇▇▇▇▇" 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:

Birth Date. Age: Home School: Grade: