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Form preview Dv 001 standard domestic relat... STATE OF MICHIGAN. STANDARD DOMESTIC ... DV-001 (10/02). AUTHORITY: 2001 PA .... Document Detailed Description of Demeanor. Victim. Suspect.
Form preview Standard form 1113 PUBLIC VOUCHER FOR TRANSPORTATION CHARGES VOUCHER OR SCHEDULE NO. See FPMR (41 CFR) 101-41 for Instructions on Completing this Form. PAID DATE DEPARTMENT OR AGENCY, BUREAU OR SERVICE, AND LOCATION
Form preview Leader recommendation form Spiritual Leader Recommendation Form Office Use Only ID A. To BE COMPLETED BY the applicant for admission Give this form to a minister pastoral staff member youth leader Bible study or small group leader who knows you well but is not related to you. Name of Applicant Address City/State/Zip Code The Family Educational Rights and Privacy Act of 1974 provides permission for a matriculated student to have access to his/her file unless a waiver of that right has been signed* If you wish to waive your rights of access to your file sign your name in the space provided* I HEREBY WAIVE MY RIGHT OF ACCESS TO THIS LETTER OF RECOMMENDATION* SIGNATURE OF APPLICANT DATE The above-named applicant is applying for admission to Point Loma Nazarene University. The Admissions Committee finds candid thorough evaluations invaluable in the decision-making process. Please include any information that you feel is pertinent and remember that your prompt appraisal of the candidate will help to assure full consideration* 1. I have known the applicant for year s in the following capacity. 2. I recommend the applicant o Enthusiastically o Strongly o Fairly Strongly o With Reservation Evaluator s Name please print o Not Recommended Phone Email address Title or Position Church/Organization Evaluator s Signature Date Are you a PLNU Alum o Yes o No 3. Please rate the applicant in each of the following categories Below average Good ExcellenT top 10 Exceptional Top 2-3 No basis for judgment Level of church involvement Level of involvement in outreach Responsibility/Accountability Self-discipline Emotional Maturity Leadership Spiritual Development Respect for Cultural Differences 4. In order for the Admissions Committee to best evaluate the applicant s spiritual fit please elaborate or qualify your evaluative marks concerning the applicant s spiritual capabilities. If you would like to expand your evaluation please feel free to submit a separate letter of name as the subject. Name of Applicant Address City/State/Zip Code The Family Educational Rights and Privacy Act of 1974 provides permission for a matriculated student to have access to his/her file unless a waiver of that right has been signed* If you wish to waive your rights of access to your file sign your name in the space provided* I HEREBY WAIVE MY RIGHT OF ACCESS TO THIS LETTER OF RECOMMENDATION* SIGNATURE OF APPLICANT DATE The above-named applicant is applying for admission to Point Loma Nazarene University. The Admissions Committee finds candid thorough evaluations invaluable in the decision-making process. The Admissions Committee finds candid thorough evaluations invaluable in the decision-making process. Please include any information that you feel is pertinent and remember that your prompt appraisal of the candidate will help to assure full consideration* 1. Please include any information that you feel is pertinent and remember that your prompt appraisal of the candidate will help to assure full consideration* 1. I have known the applicant for year s in the following capacity. 2. I recommend the applicant o Enthusiastically o Strongly o Fairly Strongly o With Reservation Evaluator s Name please print o Not Recommended Phone Email address Title or Position Church/Organization Evaluator s Signature Date Are you a PLNU Alum o Yes o No 3.
Form preview 12a200 kentucky income tax ins... GENERAL INSTRUCTIONS If you are unable to pay the full amount due with your individual income tax return, you may request an installment agreement by completing this form and mailing it to: Division
Form preview Income tax closing agreement f... *130253 19999* DR 0253 (08/30/13) colorado department of revenue Denver, CO 80261-0005 www.TaxColorado.com Income Tax Closing Agreement I. Taxpayer for which/whom agreement is sought Last Name First
Form preview Reaffirmation agreement form 2... Note also If you complete Part E you must prepare and file Form 240C ALT - Order on Reaffirmation Agreement. B240A/B ALT Form 240A/B ALT Reaffirmation Agreement 12/11 G Presumption of Undue Hardship Check box as directed in Part D Debtor s Statement in Support of Reaffirmation Agreement. Consult your credit agreement. Form 240A/B ALT - Reaffirmation Agreement Cont. ANNUAL PERCENTAGE RATE The annual percentage rate can be disclosed in different ways depending on the type of debt. UNITED STATES BANKRUPTCY COURT District of In re Debtor Case No* Chapter REAFFIRMATION AGREEMENT Indicate all documents included in this filing by checking each applicable box. G Part A Disclosures Instructions and Notice to Debtor pages 1 - 5 G Part D Debtor s Statement in G Part B Reaffirmation Agreement G Part E Motion for Court Approval G Part C Certification by Debtor s Attorney Note Complete Part E only if debtor was not represented by an attorney during the course of negotiating this agreement. Name of Creditor G Check this box if Creditor is a Credit Union as defined in 19 b 1 a iv of the Federal Reserve Act PART A DISCLOSURE STATEMENT INSTRUCTIONS AND NOTICE TO DEBTOR DISCLOSURE STATEMENT Before Agreeing to Reaffirm a Debt Review These Important Disclosures SUMMARY OF REAFFIRMATION AGREEMENT This Summary is made pursuant to the requirements of the Bankruptcy Code. AMOUNT REAFFIRMED The amount of debt you have agreed to reaffirm accrued as of the date of this disclosure. Your credit agreement may obligate you to pay additional amounts which may come due after the date of this disclosure. a* If the debt is an extension of credit under an open end credit plan as those terms are defined in 103 of the Truth in Lending Act such as a credit card the creditor may disclose not applicable the simple interest rate shown in ii below or both. i The Annual Percentage Rate disclosed or that would have been disclosed to the debtor in the most recent periodic statement prior to entering into the reaffirmation agreement described in Part B below or if no such periodic statement was given to the debtor during the prior six months the annual percentage rate as it would have been so disclosed at the time of the disclosure statement. --- And/Or -- ii The simple interest rate applicable to the amount reaffirmed as of the date this disclosure statement is given to the debtor. If different simple interest rates apply to different balances included in the amount reaffirmed the amount of each balance and the rate applicable to it are creditor may disclose the annual percentage rate shown in I below or to the extent this rate is not readily available or not applicable the simple interest rate shown in ii below or both. disclosed to the debtor in the most recent disclosure statement given to the debtor prior to entering into the reaffirmation agreement with respect to the debt or if no such disclosure statement was given to the debtor the annual percentage rate as it would have been so disclosed.
Form preview Divoce agreement myanmar form Complete all sections of this page. Do not leave any blanks. I-20/DS-2019 Request Form International Office - Northwestern University Section I: Biographical Information Type your name EXACTLY as
Form preview Client agreement employer bene... Portfolio Advisory Services CLIENT AGREEMENT Please keep this Client Agreement for your records. 1. General Agreement. This Client Agreement (Agreement) specifies the terms and conditions under which
Form preview 2008 cardmember agreement form I request that AMEX issue me with the BMW Card from American Express including any renewal or replacement Cards. Any Credit Card issued to operate the Account which will be The BMW Card from American Express Card Anniversary Date The date one year after we open your Account and the same date in subsequent years. USE OF PERSONAL INFORMATION We will disclose information about you your application for the card your Card Account and charges on your C...
Form preview Blank pet adoption application... Vernon County Humane Society P.O. Box 185 Viroqua, WI 54665 608-637-6955 Date of Application: Time of Day: Dog Name (if selected): Application Accepted By: DOG ADOPTION APPLICATION Please read this
Form preview General staffing agreement for... General Staffing Agreement This basic four-page contract form is a general agreement for staffing services. EMPLOYEE WITNESS Sample Confidentiality Agreement for Assigned Employees This sample has been prepared to accompany the General Staffing Agreement and if used would apply to the specific staffing client that is party to the agreement. CLIENT Signature Printed Name Title Date Sample Rate Schedule Job Title or Description Shift Location Hourly Bill Rate Sample Benefits Waiver for Assigned Employees This sample employee waiver language has been prepared to accompany the General Staffing Agreement and if used would apply to the specific staffing client that is party to the agreement. It is intended for use where there is no existing written contract with the client and can be offered in lieu of the client s standard contract form* It is based on the simple principle of Whose business is it that each party is responsible for the risks associated with its own business and that each party has a duty to indemnify the other only for those risks. Accompanying exhibits are sample formats for rate schedules assigned employee benefit waivers and assigned employee confidentiality agreements. This document also includes optional provisions that may need to be added to the basic document depending on the particular operational policies of the staffing firm or the terms of the deal* This contract is provided as a Word document to facilitate and encourage staffing firms to revise customize and optimize the contents for their particular circumstances and uses. Contents Exhibit A Sample Rate Schedule Optional Provisions Reports Background Checks On-Site Coordinator Guarantee Insurance Client-Recruited Employees Conversion Workout Period Credit for Past Service Minimum Hours Per Day Late Payment Penalty No Staff Hire-Aways Fee Financial Audit Nature of Relationship Headings Arbitration Contract Interpretation Choice of Law Assignment of Agreement with its principal office located at STAFFING FIRM and with its principal office located at Agreement the Agreement. STAFFING FIRM s Duties and Responsibilities 1. STAFFING FIRM will a* Recruit screen interview and assign its employees Assigned Employees to perform the type of work described on Exhibit A under CLIENT s supervision at the locations specified on Exhibit A b. Pay Assigned Employees wages and provide them with the benefits that STAFFING FIRM offers to them c* Pay withhold and transmit payroll taxes provide unemployment insurance and workers compensation benefits and handle unemployment and workers compensation claims involving Assigned Employees d. Require Assigned Employees to sign agreements in the form of Exhibit B acknowledging that they are not entitled to holidays vacations disability benefits insurance pensions or retirement plans or any other benefits offered or provided by CLIENT and before they begin their assignments to CLIENT. CLIENT s Duties and Responsibilities 2. CLIENT will a* Properly supervise Assigned Employees performing its work and be responsible for its business operations products services and intellectual property permit Assigned Employees to operate any vehicle or mobile equipment or entrust them with unattended premises cash checks keys credit cards merchandise confidential or trade secret information negotiable instruments or other valuables without STAFFING FIRM s express prior written approval or as strictly required by the job description provided to c* Provide Assigned Employees with a safe work site and provide appropriate information training and safety equipment with respect to any hazardous substances or conditions to which they may be exposed at the work site d.
Form preview Sample associate form Sample Associate Contract Veterinary Associate Employment Agreement This agreement is made this Day day of Month and Year between Hospital Name hereinafter called the hospital or owners and associate name hereinafter called the associate. The parties hereto have discussed what amount would be equitable and fair on liquidated damages and have mutually agreed that a sum equal to two years base salary shall be the amount of liquidated damages that the associate would be liable to the employer should the associate breach the covenant not to compete. Notice Any and all notices referred to herein shall be sufficient if furnished in writing and sent to the representative parties at the addresses subscribed below following the signatures to this agreement or to the last addresses furnished to the hospital. If at the end of a 12 month period following the first day of association as per this agreement both parties feel that their arrangement and relationship have been satisfactory an agreement shall be developed outlining the terms of a partnership buy-in. agreement. This agreement contains the sole and entire agreement of the parties with respect to the subject matter thereof. Any and all prior discussions negotiations commitments and understandings relating thereto are merged herein. Courtesy of the Veterinary Hospital Managers Association Sample Document Library. The hospital hereby employs the associate and the associate hereby accepts such employment for the period of twelve months from the date of this agreement. The hospital administrator referred to herein is manager name. Employment and Duties provided in this agreement. The associate agrees to perform such duties as may be determined and assigned by the owners. The associate shall faithfully adhere to the ethical principles of the veterinary profession and shall avoid all personal acts that might injure the professional and/or personal reputation of the hospital or it s owners. The associate shall be obligated to maintain all licenses and accredidations through the duration of this Agreement. by the decisions of the owner with regard to the diagnosis and treatment of any patient. In no instance shall the associate be required to perform what he/she feels compromises his/her best professional judgment or ideals. Terms Except in the case of earlier termination as hereinafter specially provided the term of this contract shall be twelve 12 months from the effective date hereof* No less than ninety 90 days prior to the end of this agreement contract of employment. Work Schedule The associate is to work a schedule of a minimum of forty hours per week. The associate is to arrive at work on time and fully prepared to assume his/her duties. The outpatient hours and surgical schedule are set up for the convenience of our patients not our associate. An established 1 hour lunch break is provided for in the schedule and is included in the forty hours. records and to have made all telephone calls before leaving for the day. For all on call emergencies the associate will be paid 20 the total charges paid by client.

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