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Form preview Atm request form FROST PERSONAL ATM CHECKCARD REQUEST FORM PERSONAL INFORMATION Name limit 20 characters Address City Daytime Phone E-mail Address State Zip Code Check here if this is an address change that applies to your primary checking account only. Requestor s Signature Date Please sign request form and mail to CIF Department Frost P. O. Box 1600 San Antonio TX 78296 Note Each cardholder must be a signer on each account listed. The primary account for a Frost ATM Checkcard cannot be a savings account. ACCOUNTS FOR ACCESS PERSONAL ACCOUNTS ONLY My primary checking account number is My primary savings account number is OTHER BANK ACCOUNTS I WISH TO ACCESS WITH MY CARD REQUESTOR MUST BE A SIGNER ON EACH ACCOUNT LISTED Account Numbers Savings Checking Money Market High Yield Money Market Authorization By signing below I am requesting a Frost ATM Checkcard. I agree the Service will be governed by the Agreement and Disclosure for Personal Checkcard Health Savings Account Checkcard and ATM card which is amended from time to time. I will receive the Agreement when the card is issued and my use of the card issued in connection with the Service will confirm that I have reviewed the Agreement and will bond me to its terms. A courier fee may apply to cards that require special handling. Card will be mailed to the above address. You will receive your card in the mail 3-5 business days from the time your request form is received* Your personal identification number PIN will be sent in a separate mailing. ACCOUNTS FOR ACCESS PERSONAL ACCOUNTS ONLY My primary checking account number is My primary savings account number is OTHER BANK ACCOUNTS I WISH TO ACCESS WITH MY CARD REQUESTOR MUST BE A SIGNER ON EACH ACCOUNT LISTED Account Numbers Savings Checking Money Market High Yield Money Market Authorization By signing below I am requesting a Frost ATM Checkcard. I agree the Service will be governed by the Agreement and Disclosure for Personal Checkcard Health Savings Account Checkcard and ATM card which is amended from time to time. I agree the Service will be governed by the Agreement and Disclosure for Personal Checkcard Health Savings Account Checkcard and ATM card which is amended from time to time. I will receive the Agreement when the card is issued and my use of the card issued in connection with the Service will confirm that I have reviewed the Agreement and will bond me to its terms. A courier fee may apply to cards that require special handling. Card will be mailed to the above address. You will receive your card in the mail 3-5 business days from the time your request form is received* Your personal identification number PIN will be sent in a separate mailing. ACCOUNTS FOR ACCESS PERSONAL ACCOUNTS ONLY My primary checking account number is My primary savings account number is OTHER BANK ACCOUNTS I WISH TO ACCESS WITH MY CARD REQUESTOR MUST BE A SIGNER ON EACH ACCOUNT LISTED Account Numbers Savings Checking Money Market High Yield Money Market Authorization By signing below I am requesting a Frost ATM Checkcard. I agree the Service will be governed by the Agreement and Disclosure for Personal Checkcard Health Savings Account Checkcard and ATM card which is amended from time to time. I will receive the Agreement when the card is issued and my use of the card issued in connection with the Service will confirm that I have reviewed the Agreement and will bond me to its terms.
Form preview Home credit application form The following documents are required to process the Home Equity Line of Credit Application Application signed and fully completed front and back Provide the following documents a and b to Applicant at the time of application a. Disclosure attached to application b. When Your Home Is On The Line Brochure which is ordered as Item No. 010284 on a Bank Materials/Service/Check Requisition form and attaching it to an E-mail to Purchasing/MaterialsManagement umb. UMB i1150037 R 04/09 Branch Name/No* Interviewer Rate Quoted Priority Source Code Financial Facts - 009 Source Financial Facts - 009 Closing Location Home Equity Line of Credit Application u n der 1 0 0 00 0 Not for purpose of home purchase or refinance of primary mortgage of principal dwelling. AMOUNT REQUESTED We may require additional information for credit lines exceeding 100 000. SUBJECT PROPERTY STREET ADDRESS CITY CURRENT MARKET VALUE YEAR ACQUIRED MORTGAGE HOLDER COUNTY STATE ZIP ORIGINAL COST AMOUNT OF EXISTING LIENS APPLICANT Name Date of Birth Street City State Zip Marital Status Married Separated Unmarried Includes Single Divorced and Widowed of Employer Position Title Social Security Number Years on This Job Home Phone Business Phone Ext. IF EMPLOYED IN CURRENT POSITION FOR LESS THAN TWO YEARS COMPLETE THE FOLLOWING A/C Previous Employer/School Type of Business Dates From/To Monthly Income GROSS MONTHLY INCOME Applicant ITEM Base Empl* Income DESCRIBE OTHER INCOME Total NOTICE Alimony child support or separate maintenance income need not be revealed if the Applicant or Co-Applicant does not choose to have it considered as a basis for repaying this loan* Other Before completing see Notice Under Describe Other Income at right. TOTAL Monthly Amount Account Information Checking and Savings Accounts Show Names of Institutions/Account Numbers Bank S L or Credit Union Average Balance Alimony Child Support Separate Maintenance Payments Owed To Monthly Payment SCHEDULE OF REAL ESTATE OWNED If Additional Properties Owned Attach Separate Schedule Address of Property Indicate S if Sold PS if Pending Sale or R if Rental Being Held for Income S PS or R Type of Property Present Market Value Mortgage Holder Amount of Mortgages Liens Mortgage Payments Net Rental Income If I am eligible I would like to receive a Visa Platinum card for the sole purpose of accessing my home equity line of credit. INDIVIDUAL APPLICANT. Check if you are applying for individual credit in your own name and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested complete Applicant section* maintenance or the income or assets of another person as the basis for repayment OR if you are married and reside in or the property is located in a community property state. Complete Applicant section and Co-Applicant section to the extent possible. Our bank complies with Section 326 of the USA PATRIOT ACT. This law mandates that we verify certain information about you while processing your account application* Credit Life and Accident and Health Insurance are not deposits or other obligations of or guaranteed by UMB Bank or any affiliate of UMB Financial Corporation* agency UMB Bank or any affiliate of UMB Financial Corporation* Insurance products may be purchased from an agent or broker of the applicant s choice.
Form preview Aarp medicare supplement appli... AARP Medicare Supplement Insurance Plans Application Form Insured by UnitedHealthcare Insurance Company Horsham PA 19044 Instructions 1. Use CAPITAL letters. 3. Fill in the circles with black or blue ink. Not pencil. Example Y N AARP Membership Number If you are already a member First Name MI Last Name Address Line 1 If you are not already an AARP Member please include your AARP Membership Application and a check or money order for your annual Membership dues with this application. City ST Zip Note Plans and rates described in this package are good only for residents of Florida Tell us about yourself Birthdate M M D D Please supply the following information found on your Medicare card. NAME Gender M MEDICARE Y Y Y Y F First / Middle Initial / Last MEDICARE CLAIM HOSPITAL PART A EFFECTIVE DATE Phone MEDICAL PART B EFFECTIVE DATE Area Code and Phone Number E-mail address optional HEALTH INSURANCE ARE BOTH MEDICARE PARTS A B COVERAGE ACTIVE By providing your email address you are agreeing to receive important account information and product offers. Be sure to write all necessary periods. and symbols in their space. 2460720307 S03Q43AGMMFL02 01B L Continued on next page Page 1 of 7 0000001 0000045 0045 0060 UMS1217 01 L If you have smoked cigarettes or used any tobacco product at any time within the past twelve months darken this circle Choose your plan and effective date Coverage Effective Date Please indicate your plan choice below A B C K Select Plan C You are eligible to enroll if all of these are true you are an AARP member you are age 50 or older you are enrolled in Medicare Parts A B you are not duplicating Medicare supplement coverage if you are not yet age 65 you are eligible only if you enrolled in Medicare Part B within the last 6 months unless you are an Eligible Person entitled to guaranteed acceptance as shown in the enclosed Your Guide. Fill in all requested information on this form and be sure to sign where indicated* 2. Print clearly. Use CAPITAL letters. 3. Fill in the circles with black or blue ink. Not pencil* Example Y N AARP Membership Number If you are already a member First Name MI Last Name Address Line 1 If you are not already an AARP Member please include your AARP Membership Application and a check or money order for your annual Membership dues with this application* City ST Zip Note Plans and rates described in this package are good only for residents of Florida Tell us about yourself Birthdate M M D D Please supply the following information found on your Medicare card. NAME Gender M MEDICARE Y Y Y Y F First / Middle Initial / Last MEDICARE CLAIM HOSPITAL PART A EFFECTIVE DATE Phone MEDICAL PART B EFFECTIVE DATE Area Code and Phone Number E-mail address optional HEALTH INSURANCE ARE BOTH MEDICARE PARTS A B COVERAGE ACTIVE By providing your email address you are agreeing to receive important account information and product offers. Be sure to write all necessary periods. and symbols in their space. 2460720307 S03Q43AGMMFL02 01B L Continued on next page Page 1 of 7 0000001 0000045 0045 0060 UMS1217 01 L If you have smoked cigarettes or used any tobacco product at any time within the past twelve months darken this circle Choose your plan and effective date Coverage Effective Date Please indicate your plan choice below A B C K Select Plan C You are eligible to enroll if all of these are true you are an AARP member you are age 50 or older you are enrolled in Medicare Parts A B you are not duplicating Medicare supplement coverage if you are not yet age 65 you are eligible only if you enrolled in Medicare Part B within the last 6 months unless you are an Eligible Person entitled to guaranteed acceptance as shown in the enclosed Your Guide.
Form preview Trade support form Trade Support Loans Application Form Purpose of this form The information that you provide in this form will be used to assess whether you are qualified to receive support through the Trade Support Loans Programme the Programme. I have read and understood the information on this form and to the best of my knowledge the details entered on this claim by me and in relation to me are true and correct. Signature of Australian Apprentice Date read the supplementary information regarding Trade Support Loans and minors. Under-18s I certify that if I am under the age of 18 I have read and understood the information outlined in the Trade Support Loans under-18s fact sheet that has been provided to me by my Australian Apprenticeships Centre. I have read and understood the information on this form and to the best of my knowledge the details entered on this claim by me and in relation to me are true and correct. You may wish to make and keep a copy of the form for your records and submit the original form to your Australian Apprenticeships Centre at the address shown on the next page. Taxation Payments received under the Programme are not income and therefore not subject to income tax. Fact Sheets Please note the following three Fact Sheets which provide you with more information on the Trade Support Loans Programme The fact sheets are available at www. Fact Sheets Please note the following three Fact Sheets which provide you with more information on the Trade Support Loans Programme The fact sheets are available at www. a ustralianapprenticeships. gov.au. Evidence of residency If you submit your application form in person you are required to bring document/s that prove that you reside in Australia and that you are an Australian Citizen or the Holder of a permanent visa. For example your birth certificate certificate of citizenship visa or passport. Act 1995. where required to do so under the Trade Support Loans Act 2014 I may be imprisoned for up to 12 months. I understand and consent that the information provided in this form is collected for the purposes of registration preparing statistics reporting program administration monitoring and evaluation ensuring correctness of payments preventing dual payments and assessment of my eligibility in relation to any future application I may make may be disclosed to and used for these purposes by the Australian Government including but not limited to the Department of Industry Centrelink the Australian Taxation Office State/Territory government departments and agencies employers my nominated Australian Apprenticeships Centre nominated Registered Training Organisations and the Contractors or Agents of any of these organisations departments and agencies and may otherwise be disclosed without my consent where authorised or required by law. 2014 to collect my tax file number. be able to obtain a Trade Support Loan if I do not provide my tax file number. Please read and sign this form and return to your Australian Apprenticeships Centre. NOTE any alterations made to this form must be made by crossing out the incorrect information and inserting the correct information do not use correction fluid pencil or stickers when completing this form unsigned or incomplete forms will not be processed and will be returned to you for completion original signatures are required on the original copy of the form and submitted either in person or by mail or it will not be processed i.e. photocopied scanned or digitised signatures will not be accepted payments will be paid by direct credit into an account nominated and maintained by you either alone or jointly and if you are under 18 years of age you are encouraged to seek the acknowledgment of a parent or guardian to demonstrate that y ou understand that the Trade Support Loan must be repaid in accordance with the Trade Support Loans Act 2014. Addition to any indexation that may be applied to the amount borrowed when my income reaches the repayment income threshold for more information contact your Australian Apprenticeships Centre. Act 1995. where required to do so under the Trade Support Loans Act 2014 I may be imprisoned for up to 12 months. I understand and consent that the information provided in this form is collected for the purposes of registration preparing statistics reporting program administration monitoring and evaluation ensuring correctness of payments preventing dual payments and assessment of my eligibility in relation to any future application I may make may be disclosed to and used for these purposes by the Australian Government including but not limited to the Department of Industry Centrelink the Australian Taxation Office State/Territory government departments and agencies employers my nominated Australian Apprenticeships Centre nominated Registered Training Organisations and the Contractors or Agents of any of these organisations departments and agencies and may otherwise be disclosed without my consent where authorised or required by law.
Form preview Fhog form application First Home Owner Grant Act 2000 Section 16 2 Form FHOG 2 Version 3 1 August 2013 Application form and lodgement guide Guide to applying for the Great Start Grant Keep this guide for future reference. It contains important information about the grant and your obligations after you receive the grant. The general information in this guide does not cover every aspect of the First Home Owner Grant Act 2000 the Act. The Great Start Grant is available for eligible transactions to buy or build a new home dated on or after 12 September 2012. Do not use this form for transactions to purchase an established home dated before 11 October 2012 or to buy or build a new home before 12 September 2012. For an explanation of the terms used in this guide see page 4. By completing and lodging this form you are declaring that you are eligible for the grant and will comply with your obligations. It is an offence to provide false or misleading information to the Commissioner to receive the grant. If you are unsure about any of your obligations or any of the information required in the application visit our website https //greatstartgrant. osr. qld. gov*au or contact the Office of State Revenue OSR on 1300 300 734. If your application is approved and the grant is paid you will be notified in writing of the conditions you are required to satisfy including the residence requirement. If you are unable to satisfy any of these conditions you must notify the Commissioner within 14 days of becoming aware that you are unable to comply with the requirement and repay the grant. If you do not meet these obligations you may be penalised and required to repay the grant. Requirements Applicants must ensure the application is completed in full an incomplete application will not be accepted l odge the completed application and all supporting documents within 12 months of completion of the eligible transaction b e a natural person i*e* not a company at least 18 years of age at the commencement of the eligible e nsure at least one applicant is an Australian citizen or a permanent resident at the time of applying for the grant e buying or building a new home where the contract date is on or after 12 September 2012 or building a home as an owner-builder where the laying of the foundations commenced on or after 12 September 2012 ensure each person holding a relevant interest in the property is an applicant nsure all applicants will reside in the new home as their principal place of residence for a continuous period of at least 6 months commencing within 12 months of completion of the eligible transaction* Applicants and their spouses must not have previously owned or held a relevant interest in residential property anywhere in Australia before 1 July 2000 residential property in which they acquired a relevant interest anywhere in Australia on or after 1 July 2000 p reviously received a first home owner grant in any state or territory of Australia* If a grant was received from the Queensland Office of State Revenue that you later paid back together with any penalty you may be entitled to reapply for the grant.
Form preview Canada form spouse 2013 2019 IMM 5490 08-2013 E DISPONIBLE EN FRAN AIS - IMM 5490 F Do you have family members or other relatives i.e. aunt uncle cousin etc. living in Canada Provide their full name s address es and relationship to you. Citizenship and Immigration Canada Citoyennet et PROTECTED WHEN COMPLETED - B PAGE 1 OF 6 SPONSORED SPOUSE/PARTNER QUESTIONNAIRE To be completed by persons living outside Canada and being sponsored as spouses common-law partners or conjugal partners This document must be completed and included with your application for permanent residence in Canada if you are being sponsored by your spouse common-law partner or conjugal partner. Provide a complete and precise response to each question. Failure to provide this information will delay processing and could result in a refusal of your application. Indicate your name the form s title and the number or letter of the question you are answering on all additional sheets of paper on which you will provide your answers. Provide a complete and precise response to each question* Failure to provide this information will delay processing and could result in a refusal of your application* Indicate your name the form s title and the number or letter of the question you are answering on all additional sheets of paper on which you will provide your answers. A number of the following questions ask that you provide documentary proof* For expediency and security reasons do not include documents containing mechanical or electronic devices such as musical greeting cards nor containers / storage components for pictures such as binders albums frames video discs DVDs or video cassettes. BEFORE YOU START READ THE INSTRUCTION GUIDE* TYPE or PRINT in black ink. FIRST CONTACT Did you have any contact with your sponsor before you met in person No Yes Day When did you first contact your sponsor Month Year How did you first contact your sponsor e*g* by phone letter e-mail etc FIRST MEETING When and where did you first meet your sponsor in person Date Place Did anyone individual or organization introduce you to your sponsor Name of individual or organization Date of introduction Relationship to you to your sponsor Did you give your sponsor any gifts Specify Did your sponsor give you any gifts Give any additional details describing the circumstance of your first meeting with your sponsor. If insufficient space use a separate sheet of paper. FAMILY MEMBERS Prior to your spousal/common-law/conjugal partner relationship was your sponsor or any of your sponsor s family members related to you or any member of your family Give their names and relationship to you or your sponsor as applicable. NAME RELATIONSHIP TO YOU OR YOUR SPONSOR This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants. NAME AND ADDRESS DEVELOPMENT OF YOUR RELATIONSHIP Describe how your relationship developed after your first contact/meeting with your sponsor and if you and your sponsor dated or went on any outings or trips together.
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