Daytime Phone Number definition

Daytime Phone Number. Email address: Name: Title: Name of their organization: Role of this collaborator: Daytime Phone Number: Email address: (Copy if more are required) • Names and contact information and credentials of Collaborative Practice Agreement (CPA) team members; • Practice Model and Organization of Care – specify the type of team and how patient care will be organized; • Roles and responsibilities of CPA team members – based upon an understanding of each team member’s practice area, defining each CPA team member’s roles and responsibilities; • Coordination of care – agree on who is responsible for coordination of care and team leadership, and specify the decision-making processes;

Split View

AI-Powered Contracts

Draft, Review & Redline at the Speed of AI

Get StartedSchedule a Demo

Daytime Phone Number. Mailing Address: _ City: _ S ▇ ▇ ▇ ▇ : Zip: Email Address:

Daytime Phone Number. Email: Owner/Authorized Signature: Date: Title (if Corporation): (President, CEO, etc.) Agent/Company Name: PAR Residential Mailing Address: ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ St. Louis, MO 63105 Daytime Phone Number: ▇▇▇-▇▇▇-▇▇▇▇ Email: ▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ Agent’s Signature: Date: Title (if Corporation): Partner (President, CEO, etc.) Property Locator/Account Number(s): Property Address(es): (Complete additional authorization forms, if needed) (Agency Auth. 2011) Property Address: Date Purchased Purchase Price Please describe circumstances of sale (bank owned, short sale, property was listed with a realtor etc.) _ Is the property rented? If so, rent per month (per unit) $ Date of Last Appraisal (for refinance, etc) Appraised Value Please provide a copy of your sale contract, closing statement or any appraisal you may have from the last 3 years.

Examples of Daytime Phone Number in a sentence

• Signature Guaranteed Name of Warrantholder Name of Authorized Representative Signature of Warrantholder or Authorized Representative Title or Capacity or Authorized Representative Daytime Phone Number of Warrantholder or Authorized Representative Note: The signature to this transfer must correspond with the name as recorded on the Warrants in every particular without alteration or enlargement or any change whatever, or accompanied by stock powers of attorney satisfactory to the Warrant Agent.

• Signature Guaranteed Name of Warrantholder Name of Authorized Representative Signature of Warrantholder or Authorized Representative Title or Capacity or Authorized Representative Daytime Phone Number of Warrantholder or Authorized Representative Note: The signature to this transfer must correspond with the name as recorded on the Warrants in every particular without alteration or enlargement or any change whatever.

• Member (Name): _________________________________________ E-Mail Address: __________________________________________ US Mail Address: __________________________________________ City: ____________________ State: __________________Zip Code: _____________ Daytime Phone Number: ___________________ Note: Attach application fee and 1-line (electrical drawing of installation) with application.

• Parent or Guardian (Please print): _ Signature: _ _ _ _ _ _ _ _ _ _ Date: _ / _ / _ Daytime Phone Number: _ _ _ Evening Phone Number: _ _ _ I acknowledge that I have received a copy of the Spotsylvania County Schools Staff Time Schedules.

• Participant Information Employee Name (Printed) Employee ID 00000- Last four digits of SSN Daytime Phone Number E-mail Address (to receive an e-mail confirmation) *IMPORANT: All changes to the 457(b) plan must be received by the end of the month prior to the requested effective date.

• Signature Guaranteed Name of Special Warrantholder Name of Authorized Representative Signature of Special Warrantholder or Authorized Representative Title or Capacity of Authorized Representative Daytime Phone Number of Special Warrantholder or Authorized Representative The signature of the Holder must be the signature of the registered holder appearing on the face of this Special Warrant Certificate.

• Parent or Guardian (please print) Signature Date: / / Daytime Phone Number ( ) - Evening Phone Number ( ) - SPONSORING TEACHER I have read the Terms and Conditions and agree to promote this agreement with the student.

• Signature Guaranteed (Signature of Warrantholder) Print full name Print full address Social Insurance Number Daytime Phone Number  Please check if the share certificate(s) are to be picked up at the office of the Warrant Agent where this Warrant Certificate is surrendered, failing which such certificates will be mailed.

• Describe any other information you feel is important for the teacher to know to better meet your child’s needs: Date: Child’s Name: Name of Responsible Party: Address: Daytime Phone Number: Evening Phone Number: All students must pay a non-refundable registration fee of $125.00 regardless of enrollment date.

• Claimant Name: ___________________________________ ___ ___________________________________ Street Address: Street Address2: City: State: Zip Code: [optional] Daytime Phone Number: ( ) - [optional] Evening Phone Number: ( ) - [optional, unless you select a Credit Certificate] E-mail Address: [optional] Class Member ID: If you received a notice of this Settlement by U.S. mail, your Class Member ID is on the envelope or postcard.

More Definitions of Daytime Phone Number

Daytime Phone Number. Evening Phone Number: Fax Number: Email Address: Occupancy Date: By signing below you confirm that you are entering into a contract with EnerCare Connections Inc. (“EnerCare”) for the provision by EnerCare of the Energy Services (as defined below) and for payment by you for the Energy Services provided by EnerCare and that you have read and agree to the terms and conditions set forth below and you agree that such terms and conditions are subject to EnerCare’s Conditions and Services (the “Conditions of Service”) in effect from time to time and made available on EnerCare’s website and which are subject to amendment from time to time in EnerCare’s sole discretion provided notice thereof is provided to you.

Daytime Phone Number. Cell Phone: