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Form preview Ncis 757 form 2006-NCIS 757 Rev. 10-2006 CROP-HAIL INSURANCE and/or MULTIPLE PERIL CROP INSURANCE ASSIGNMENT OF INDEMNITY Approved Insurance Provider s Name Address Policy Number Insured s Name Effective Crop Year Insured s Authorized Representative Crop Name and County Name Street or Mailing Address City State Zip Code The insured assigns to Name of Creditor of Mailing Address City State and Zip Code the right and interest of any indemnity payment s which may be payable to the insured under the insurance policy for the county/commodity ies shown above. CONDITIONS This assignment will be binding upon the person s who succeed the Insured s interest in the insurance policy. Indemnity payments made under the insurance policy will be subject to a deduction for any indebtedness due this Approved Insurance Provider by the Insured* The Creditor s interest will be recognized upon Approved Insurance Provider s approval of this assignment and the Creditor will have the right to submit the loss notices and other forms as required by the Policy. The Approved Insurance Provider will determine the person s entitled to any indemnity payment s and the payment s will be by joint check. If the assignment is not cancelled according to item 7 below the assignment will cease at the end of the effective crop year. Cancellation of this assignment prior to and during the crop year stated above will be accepted by the Approved Insurance Provider only upon notification in writing by the above identified Creditor s. It is understood and agreed that this assignment will be subject to the terms and conditions of the insurance policy. Insured s Signature Date Creditor s Signature Witness Signature Approved The Insurance Provider hereby approves the foregoing assignment. at Month Day Year Authorized Representative s Signature See reverse side of form for statement required by Privacy Act of 1974. 2006 National Crop Insurance Services Inc* a*m* p*m* COLLECTION OF INFORMATION AND DATA PRIVACY ACT To the extent that the information requested herein relates to your individual capacity as opposed to your business capacity the following statements are made in accordance with the Privacy Act of 1974 as amended 5 U*S*C. 552a. The authority for requesting information to be furnished on this form is the Federal Crop Insurance Act 7 U*S*C. 1501 et seq. Act and the Federal crop insurance regulations contained in 7 C. F*R* chapter IV. Collection of the social security account number SSN or the employer identification number EIN is authorized by section 506 of the Act and is required as a condition of eligibility for participation in the Federal crop insurance program* The primary use of the SSN or EIN is to correctly identify you and any other person with an interest in you or your entity of 10 percent or more as a policyholder within the systems maintained by the Federal Crop Insurance Corporation FCIC. Furnishing the SSN or EIN is voluntary however failure to furnish that number will result in denial of program participation and benefits.
Form preview Assignment on cash deposit for... All persons whose names appear on the certificate or passbook account must sign below. Applicant s Signature This is to certify that on this day of before me the undersigned a notary public in and for the State of duly commissioned and sworn personally appeared to me known to be the person s described in and who executed the above and foregoing Assignment of Cash Deposit and he/she/they acknowledged to me that he/she/they signed and sealed it freely and voluntarily for the uses and purposes stated in the assignment. ASSIGNMENT OF CASH DEPOSIT 12 AAC 21. 120 a 2 A certificate of deposit or other negotiable instrument filed with the commissioner instead of bond must be accompanied by an Assignment of Cash Deposit signed by BOTH the contractor and bank representative acknowledging transfer to the department. For Value received the undersigned assigns and transfers to the State of Alaska the attached Certificate of Deposit No* Other Security No* and type In the amount of issued by Bank Name and Address as and for the construction contractor s surety bond as required by the laws of the State of Alaska for the registration of sole proprietor or all partners names the corporation name the LLP name or the LP name as a contractor doing business as which is a partnership corporation LLC LLP LP The undersigned irrevocably constitutes and appoints the State of Alaska by and through its duly authorized agents as its Attorney-in-Fact to do all things necessary and appropriate to effectuate the purposes of this assignment. It is agreed and understood that this assignment shall remain in full force and effect for the period of time provided by law for actions against the surety bond. WITNESS my hand and official seal on the day and year written above. Notary Seal Notary Public for the State of My Commission Expires By signature below the issuing institution agrees that only the State of Alaska upon presentation of written notice shall cause the release of any and all funds described above. ASSIGNMENT OF CASH DEPOSIT 12 AAC 21. 120 a 2 A certificate of deposit or other negotiable instrument filed with the commissioner instead of bond must be accompanied by an Assignment of Cash Deposit signed by BOTH the contractor and bank representative acknowledging transfer to the department. For Value received the undersigned assigns and transfers to the State of Alaska the attached Certificate of Deposit No* Other Security No* and type In the amount of issued by Bank Name and Address as and for the construction contractor s surety bond as required by the laws of the State of Alaska for the registration of sole proprietor or all partners names the corporation name the LLP name or the LP name as a contractor doing business as which is a partnership corporation LLC LLP LP The undersigned irrevocably constitutes and appoints the State of Alaska by and through its duly authorized agents as its Attorney-in-Fact to do all things necessary and appropriate to effectuate the purposes of this assignment.
Form preview Form trust assignment Trustee shall deliver to such purchaser its deed conveying the property so sold but without any covenant or warranty express or implied. The recitals in such deed of any matters or facts shall be conclusive proof of the truthfulness thereof. TRUSTEE First American Title Insurance Company WITH POWER OF SALE Any person including Trustor Trustee or Beneficiary as hereinafter defined may purchase at such sale. Escrow No. Order No. Loan No. WHEN RECORDED MAIL TO SPACE ABOVE THIS LINE FOR RECORDER S USE DEED OF TRUST WITH ASSIGNMENT OF RENTS SHORT FORM This DEED OF TRUST made between herein called TRUSTOR whose address is Number and Street City State FIRST AMERICAN TITLE INSURANCE COMPANY a California corporation herein called TRUSTEE and herein called BENEFICIARY WITNESSETH That Trustor grants to Trustee in trust with power of sale that property in the State of California County of City of described as together with the rents issues and profits thereof subject however to the right power and authority hereinafter given to and conferred upon Beneficiary to collect and apply such rents issues and profits for the purpose of securing 1 payment of the sum of with interest thereon according to the terms of a promissory note or notes of even date herewith made by Trustor payable to order of Beneficiary and extensions or renewals thereof 2 the performance of each agreement of Trustor incorporated by reference or contained herein and 3 payment of additional sums and interest thereon which may hereafter be loaned to Trustor or his successors or assigns when evidenced by a promissory note or notes reciting that they are secured by this Deed of Trust. To protect the security of this Deed of Trust and with respect to the property above described Trustor expressly makes each and all of the agreements and adopts and agrees to perform and be bound by each and all of the terms and provisions set forth in subdivision A and it is mutually agreed that each and all of the terms and provisions set forth in subdivision B of the fictitious deed of trust recorded in Orange County August 17. 1964 and in all other counties August 18 1964 in the book Continued on Page 2 1158 1/94 Page 1 of 4 and at the page of Official Records in the office of the county recorder of the county where said property is located noted below opposite the name of such county namely COUNTY BOOK Alameda Alpine Amador Butte Calaveras Colusa Contra Costa Del Norte El Dorado Fresno Glenn Humboldt Imperial Inyo Kern PAGE 130-31 Kings Lake Lassen Los Angeles Madera Marin Mariposa Mendocino Merced Modoc Mono Monterey Napa Nevada Orange T-3878 Placer Plumas Riverside Sacramento San Benito San Bernardino San Francisco San Joaquin San Luis Obispo San Mateo Santa Barbara Santa Clara Santa Cruz Shasta San Diego SERIES 5 A-804 149774 Sierra Siskiyou Solano Sonoma Stanislaus Sutter Tehama Trinity Tulare Tuolomne Ventura Yolo Yuba shall inure to and bind the parties hereto with respect to the property above described* Said agreements terms and provisions contained in said subdivisions A and B identical in all counties and printed on pages 3 and 4 hereof are by the within reference thereto incorporated herein and made a part of this Deed of Trust for all purposes as fully as if set forth at length herein and Beneficiary may charge for a statement regarding the obligation secured hereby provided the charge therefor does not exceed the maximum allowed by law.

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