Examples of Original Signature Date in a sentence
Typed Name of CFO/Treasurer Original Signature Date use BLUE or RED ink only Xxxxxx Xxxxx, Fiscal Officer NJHT Representative Signature Date Division Fiscal Certification: Vendor ID # GO # 022-8049800- LN 1 $ .
PRIME CONSULTANTMBE/WBE(Authorized Original Signature) Date ADDRESS:(Authorized Original Signature) Date ADDRESS:TELEPHONE #:TELEPHONE #:FEIN:FEIN:ORIGINALS:o Compliance Mgr.
SLO/ASLO Original Signature: Date: Typed Name, Title, Agency:National Environmental Policy ActNational Park Service-Land and Water Conservation Fund State Assistance ProgramCategorical Exclusions for Which a Record is NeededNote: The following are the NEPA Categorical Exclusions approved for use with all NPS programs.
Provider Original Signature Date Name – Please Type or PrintProvider Disclosure Statement Definitions The definitions below are designed to clarify certain questions on the following Ownership and Control Disclosure Forms.
We) the undersigned, agent for the firm, named below certify that the above information is true and correct to the best of my knowledge.Name/Title: Company Name: Original Signature: Date THIS FORM MUST BE RETURNED WITH YOUR BID REQUIRED FORM Name/Title: Company Name: Original Signature: DateI (We) the undersigned, agent for the firm, named below certify that the above information is true and correct to the best of my knowledge.
Typewritten Name and Title Original Signature Date ATTACHMENTS The following information must be submitted for Department review and approval prior to the issuance of the seismic operations permit.
BIDDERDBE(Authorized Original Signature) Date ADDRESS:(Authorized Original Signature) Date ADDRESS:TELEPHONE #:TELEPHONE #:FEIN:FEIN: ORIGINALS:o Compliance Mgr.
Name (Print or Type) Original Signature Date www.psychology.ca.govP (916) 574-77201625 N.
Reference’s Original Signature Date Reference Name STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this day of 20 , by.
Reference’s Original Signature Date Reference Name STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this day of 20 , by .