Claim Form Instructions definition

Claim Form Instructions means the documents in the form attached as Exhibit A to this Agreement and/or as ultimately approved by the Court.
Sample 1Sample 2Sample 3
Claim Form Instructions means the document substantially similar in form and content to Exhibit C to this Agreement or as approved by the Court.
Sample 1Sample 2Sample 3
Claim Form Instructions means the instructions to complete the Claim Form, which are attached as part of Exhibit B to this Agreement.
Sample 1

Examples of Claim Form Instructions in a sentence

  • If this information changes prior to the distribution of payments, you must notify the Claims Administrator in writing at the address noted in the Claim Form Instructions.

  • NOT BOTH).Check One:G Physician Group/Organization Please indicate the number of Physicians on your list Physician Group or Organization NameName and Title of Employee/Representative FilingPhonePhysician Groups/Organizations must attach a list of Active Physicians for whom they are submitting claims, along with the information specified in the Claim Form Instructions enclosed with this mailing for each Active Physician for whom the Physician Group/Organization is submitting a Claim.

  • ACTIVE PHYSICIAN.G By checking the box to the left, I certify that I have reviewed the enclosed Notice of Proposed Settlement and Claim Form Instructions and that I am a Class Member (as described in the enclosed Notice of Proposed Settlement and defined in the Settlement Agreement) and that I am an Active Physician.ACTIVE PHYSICIANS: Individual Physicians must check ONLY ONE of the boxes below to designate the range of Gross Receipts that are the basis of this claim.

  • Timely Filing 11-2Diagnosis & Procedure Codes 11-2Service Authorizations (SAs) 11-2Required Claim Attachments 11-3Claim Completions Requirements for CFI 11-4CMS-1500 Claim Form Instructions for CFI Providers 11-5Change LogThe Change Log is used to track all changes within this manual.

  • The website provides notice of the Settlement, the Settlement Agreement, answers to frequently asked questions, the Third Amended Class Action Complaint, the Order Preliminarily Approving Class Action Settlement, Plaintiffs’ Motion for Preliminary Approval, and Claim Form Instructions.

  • Keough, Chief Executive Officer at JND Legal Administration, the independent third-party Settlement Administrator for the Settlement, establishing that the Mail Notice, Claim Form, and Claim Form Instructions were mailed to Noticed Class Members on December 12, 2018; the Settlement Website and IVR toll-free telephone number system were established on December 12, 2018; internet advertising was published beginning December 14, 2018; and the Publication Notice was published on January 7, 2019.

  • Charitable Organization NumberCLEARLY print the number preceding the eligible organization you are selecting from the list on page 4 of the Claim Form Instructions in the box to the right.

  • The Settlement Website shall also contain Claim Form Instructions and a Claim Form which may be downloaded or printed from the Settlement Website, and a Spanish-language translation of the Website Notice, Claim Form Instructions, and Claim Form, and such other documents as Class Counsel and Allstate’s Counsel agree upon.

  • The Class Action Claim Form Instructions and a Class Action Claim Form have been sent to you with this Notice.

  • Read Question 6 in the Inflammatory Foreign Body Response Payment Claim Form Instructions (the orange edge).


More Definitions of Claim Form Instructions

Claim Form Instructions means the instructions to complete the Claim Form, which are stated on the Claim Form.
Sample 1
Claim Form Instructions means the documents in the form attached as Exhibit
Sample 1

Related to Claim Form Instructions

  • RBC instructions means the RBC report, including risk-based capital instructions adopted by the NAIC, as the RBC instructions may be amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.

  • Claim Form or “Proof of Claim Form” means the form, substantially in the form attached hereto as Exhibit 2 to Exhibit A, that a Claimant or Settlement Class Member must complete and submit should that Claimant or Settlement Class Member seek to share in a distribution of the Net Settlement Fund.

  • Proper Instructions means Written Instructions.

  • Certification Instructions You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.

  • Transfer Instructions are the information that you provide when using the Service. “Us,” “We,” and “Our” means Credit Union.

  • Proper Instruction means a writing signed or initialed by one or more person or persons as the Board shall have from time to time authorized. Each such writing shall set forth the specific transaction or type of transaction involved. Oral instructions will be deemed to be Proper Instructions if (a) FAS reasonably believes them to have been given by a person previously authorized in Proper Instructions to give such instructions with respect to the transaction involved, and (b) the Investment Company, or the Fund, and FAS promptly cause such oral instructions to be confirmed in writing. Proper Instructions may include communications effected directly between electro-mechanical or electronic devices provided that the Investment Company, or the Fund, and FAS are satisfied that such procedures afford adequate safeguards for the Fund's assets. Proper Instructions may only be amended in writing.

  • Written Instructions means (i) written communications actually received by the Custodian and signed by an Authorized Person, (ii) communications by facsimile or Internet electronic e-mail or any other such system from one or more persons reasonably believed by the Custodian to be an Authorized Person.

  • Delivery Instructions means the instructions set out in the Contract for the provision of the Goods and Services, including any other information the Authority considers appropriate to the provision of the Goods and Services.

  • Direct instruction means any instruction given by the person required to provide the notification or any person controlled by that person within the meaning of Article L. 233-3 of the Commercial Code, stipulating how the management company or the investment service provider should exercise the voting rights under given circumstances;

  • Officer's Instruction means an instruction in writing given on behalf of the Fund to FDS, and signed on behalf of the Fund by the President, any Vice President, the Secretary or the Treasurer of the Fund;

  • Escrow Instructions has the meaning ascribed to such term in Section 4.3.

  • Dispatch Instruction has the meaning set forth in the CAISO Tariff.

  • Indirect instruction means any general or specific instruction given in any form by the person required to provide the notification or any person controlled by that person within the meaning of Article L. 233-3 of the Commercial Code that limits the discretion of the management company or the investment service provider in the exercise of the voting rights in order to serve the commercial interests of the person required to provide the notification or the controlled person.

  • Transfer Instruction is a specific information provided for a transfer to be made that you provide to the Account to Account Transfer Service for a transfer of funds.

  • Instruction Letter means written instructions in a form acceptable to NCPS and executed by Issuer Party with Issuer Party directing NCPS to promptly disburse the Escrow Funds to Issuer pursuant to Section 4(a).

  • Payment Instructions has the meaning set forth in Section 5.2(a) of the Loan Agreement.

  • instructions for use means the information provided by the manufacturer to inform the user of the device’s intended purpose and proper use and of any precautions to be taken;

  • Authorized Instructions shall have the meaning set forth in Section 1.5.

  • Special Instruction Form means a standardized form prescribed by the Management Company to be duly filled by the investor to change his/her particulars and will be stated in this Offering Document.

  • Voting Instructions means the instructions for voting on the Plan contained in the section of the Disclosure Statement entitled "SOLICITATION; VOTING PROCEDURES" and in the Ballots and the Master Ballots.

  • Service Instructions means such instructions given to the Bank via any Telephone Banking Service;

  • Disbursement Instruction Agreement means an agreement substantially in the form of Exhibit M to be executed and delivered by the Borrower pursuant to pursuant to Section 6.1(a)(xi), as the same may be amended, restated or modified from time to time with the prior written approval of the Administrative Agent.

  • Transfer Agent Instruction Letter means the letter from the Company to the Transfer Agent which instructs the Transfer Agent to issue Underlying Shares pursuant to the Transaction Documents, in the form of Exhibit B attached hereto.

  • Notice and Claims Agent means Prime Clerk LLC.

  • Administrative Instructions means the Administrative Instructions under the Treaty;

  • Wire Instructions To: _____________________________________