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Form preview Nala recertification affidavit... NATIONAL ASSOCIATION OF LEGAL ASSISTANTS, INC. 1516 SOUTH BOSTON, SUITE 200, TULSA, OK 74119 918.587.6828 Fax: 918.582.6772 www.nala.org nalanet@nala.org Recertification Affidavit NOTE: This form
Form preview Affidavit of indigency florida... FINANCIAL DISCLOSURE / AFFIDAVIT OF INDIGENCY Applicant's Name Mailing Address Case No. ($25.00 application fee may be assessed--see notice on reverse side) I. PERSONAL INFORMATION D.O.B. Person Represented's
Form preview Affidavit of support clark uni... 1 000. 00 Total. 18 000. 00- 22 248. 00 Please add 3 000. 00 per each dependant on your application. Dependant Information Family Name First Name Date of Birth Country of Birth City of Birth Citizenship Relationship through personal or family sponsorship in the form of Original Bank Letter written on a bank letterhead or Original Bank Statement dated within past 3 months that includes the specific current amount in the USD and Letter From the Spo...
Form preview Shelby county affidavitpdffill... Shelby County Schools Shared Residence Affidavit This form is to be completed if residency requirements cannot be provided due to the fact that the parent and child ren are sharing a home with another person SEVEN DAYS A WEEK YEAR ROUND. I agree to notify Shelby County Schools if there is any change in the status of my residence. I understand that home visitation and/or residency verification is part of the process when residency is established by an Affidavit of Shared Residence. I agree to notify Shelby County Schools if there is any change in the status of residence of the persons listed above. I understand that home visitation and/or residence verification is part of the process when residency is established by a Shared Residence Affidavit. I understand that home visitation and/or residence verification is part of the process when residency is established by a Shared Residence Affidavit. I further agree to provide proof of my residence to Shelby County Schools. State of Tennessee County Of appeared Name s of Signer s Place Notary Seal below who proved to me on the basis of satisfactory evidence to be the person s whose name s is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity ies and that by his/her/their signature s on the instrument the person s or the entity upon behalf of which the person s acted executed the instrument. This affidavit must be re-certified through Student Services annually. All sections must be completed and signatures notarized* DO NOT SIGN THIS FORM IF ANY OF THE STATEMENTS ARE INCORRECT. Evidence of false information will result in immediate withdrawal of the student s from school* To be completed by Parent s / Guardian s Student Last Name First Name Sex M F Birth Date // Grade Please list additional students on a separate sheet. Parent s Name Address Telephone Cell Phone Other Phone This living arrangement is Temporary Duration Permanent This address listed above is my only residence. Signature of Parent/Legal Court Appointed Guardian TN Driver s License/ID Card Number Date TO BE COMPLETED BY HOMEOWNER Owner Lease Holder Qualified Relative Friend Neighbor etc* Street City Zip reside with me on a full time basis seven days a week year round. I agree to notify Shelby County Schools if there is any change in the status of residence of the persons listed above. I understand that home visitation and/or residence verification is part of the process when residency is established by a Shared Residence Affidavit. I further agree to provide proof of my residence to Shelby County Schools. State of Tennessee County Of appeared Name s of Signer s Place Notary Seal below who proved to me on the basis of satisfactory evidence to be the person s whose name s is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity ies and that by his/her/their signature s on the instrument the person s or the entity upon behalf of which the person s acted executed the instrument.
Form preview Affidavit of fact form AUSTIN, TX 78751. OF TAXES. Phone: (512) ... NO ALTERATIONS, WHITEOUT OR ERRORS ARE ACCEPTABLE ON THIS FORM. This is to state that an error ...
Form preview Tree affidavit form Is exempt from the Tree Preservation Ordinance Rights Determination is required Aka Vested Rights Permit For Residential Building Permit Tree Affidavit a 35 Review Fee and aerial photo of project area is required. All other reviews require a 250 fee and an aerial photo of project area. OR 4. D.C. and all related appendices regarding Tree Preservation and agree to adhere to the requirements including any additional fees determined to be owed to complete this permit. State of Texas County of Bexar Signature known to me to be the Before me the undersigned authority on this day personally appeared person whose name is signed to the foregoing affidavit and sworn by me states under oath that all of the facts therein set forth are true and correct. A/P City of San Antonio Development Services Department 1901 S. Alamo San Antonio TX 78204 TREE AFFIDAVIT / PERMIT APPLICATION Office Use Only INSPECTOR INITIALS DATE APPROVED NOT APPROVED PASS / FAIL INITIALS Project Address/Location Outside City Limits Project Name/Subdivision Class of Work Check as Appropriate Tree Removal Project Type Check as Appropriate Company ID Lot No. Site Work Block Platting Commercial acres New Structure Addition 2500 ft Residential lots Contact ID Public Funds Used Contact Person N Plat NCB/CB Unit Parcel Key http //maps. sanantonio. gov/imf/sites/DevServices/jsp/launch. jsp Y Company Name Email Phone Fax Owner Address Stat City Zip APPLICANT SHALL PROVIDE HABITAT COMPLIANCE FORM AS DEFINED IN 35-B133 FOR PROPERTIES 2. 0 ACRES AND LARGER. IF A MASTER TREE PERMIT TREE PLAN OR A TREE PERMIT ASSOCIATED WITH A RIGHTS DETERMINATION REVIEW WAS PREVIOUSLY APPROVED PROVIDE AP if acknowledging a previously approved tree permit as noted above no selection of 1-4 is required below PLEASE MARK THE APPROPRIATE BOX FOR REVIEW ONLY MARK ONE BOX 1. has no Protected Significant Heritage or Historic trees as defined in Article V 35-523 or 35-6111 of the U. D*C* Aerial photo required for 2003/2006 Ordinance OR 2. has protected trees but this work will in no way cause damage to or the destruction of said trees I understand such is a direct violation of the provisions of Article V 35-477B b 2 or 35-6106 Aerial photo or Tree Survey required for 2003/2006 Ordinance OR 3. has Protected Significant Heritage or Historic trees that will be removed* Requires additional site plan and tree inventory submitted I agent/owner certify that I am aware of Article V 35-523 of the U. D*C* and all related appendices regarding Tree Preservation and agree to adhere to the requirements including any additional fees determined to be owed to complete this permit. State of Texas County of Bexar Signature known to me to be the Before me the undersigned authority on this day personally appeared person whose name is signed to the foregoing affidavit and sworn by me states under oath that all of the facts therein set forth are true and correct. Sworn To Before me this day of http //www. sanantonio. gov/dsd/environmental*asp. Notary Public In And For The State of Texas.
Form preview Affidavit of birth information... Affidavit of Birth Information for Out-of-Hospital Births This Affidavit is to be Completed at the Local Health Office I swear or affirm that the information stated is true and correct to the best of my knowledge and belief. I certify that the child named herein was born alive to the stated mother at the place date and time shown on this worksheet.
Form preview Notice of death affidavit illi... NOTICE OF DEATH AFFIDAVIT AND ACCEPTANCE OF TRANSFER ON DEATH INSTRUMENT Prepared by and return to Send subsequent tax bill to The undersigned beneficiary or beneficiaries being duly sworn on oath state as follows That died on Name of Owner County Month Day Year a resident of owning residential real estate legally described below State Legal Description attach exhibit if more room is needed That the street address of the residential real estate is is City Property Identification Number PIN ATG FORM 3056 ATG REV. 3/13 Document No. Zip. That the Transfer on Death Instrument is dated No. Street Address in the Office of the Recorder for and the property identification number and recorded as Document Date County Illinois. NOTICE OF DEATH AFFIDAVIT AND ACCEPTANCE OF TRANSFER ON DEATH INSTRUMENT Prepared by and return to Send subsequent tax bill to The undersigned beneficiary or beneficiaries being duly sworn on oath state as follows That died on Name of Owner County Month Day Year a resident of owning residential real estate legally described below State Legal Description attach exhibit if more room is needed That the street address of the residential real estate is is City Property Identification Number PIN ATG FORM 3056 ATG REV. 3/13 Document No* Zip. That the Transfer on Death Instrument is dated No* Street Address in the Office of the Recorder for and the property identification number and recorded as Document Date County Illinois. FOR USE IN IL Page 1 of 2 That the undersigned whose names and addresses appear below are all beneficiaries entitled to receive under the Transfer on Death Instrument Name Address Share In witness whereof the undersigned beneficiaries hereby accept the transfer of residential real estate under the transfer on death instrument this of Signature of Beneficiary Name Print STATE OF ILLINOIS SS COUNTY OF Name s of Beneficiary ies personally known to me to be the same person or persons whose name or names are subscribed to the foregoing instrument appeared before me this day in person and swore on oath to the above foregoing affidavit. 3/13 Document No* Zip. That the Transfer on Death Instrument is dated No* Street Address in the Office of the Recorder for and the property identification number and recorded as Document Date County Illinois. FOR USE IN IL Page 1 of 2 That the undersigned whose names and addresses appear below are all beneficiaries entitled to receive under the Transfer on Death Instrument Name Address Share In witness whereof the undersigned beneficiaries hereby accept the transfer of residential real estate under the transfer on death instrument this of Signature of Beneficiary Name Print STATE OF ILLINOIS SS COUNTY OF Name s of Beneficiary ies personally known to me to be the same person or persons whose name or names are subscribed to the foregoing instrument appeared before me this day in person and swore on oath to the above foregoing affidavit.
Form preview Affidavit form b E-VERIFY AFFIDAVIT FORM B Private Employer of Compliance Pursuant to O. C. G.A. 36-60-6 d By executing this affidavit the undersigned private employer verifies that it is exempt from compliance with O. C. G*A. 36-60-6 stating affirmatively that the individual firm or corporation employs fewer than 100 employees and therefore is not required to register with/or utilize the federal work authorization program commonly known as E-Verify or any subsequent replacement program in accordance with the applicable provisions and deadlines established in O. C. G*A. 13-10-90. Signature of Exempt Private Employer Printed Name of Exempt Private Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on 201 in city state Signature of Authorized Officer or Agent Printed name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF 201. C. G*A. 36-60-6 stating affirmatively that the individual firm or corporation employs fewer than 100 employees and therefore is not required to register with/or utilize the federal work authorization program commonly known as E-Verify or any subsequent replacement program in accordance with the applicable provisions and deadlines established in O. C. G*A. 13-10-90. Signature of Exempt Private Employer Printed Name of Exempt Private Employer I hereby declare under penalty of perjury that the foregoing is true and correct. C. G*A. 13-10-90. Signature of Exempt Private Employer Printed Name of Exempt Private Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on 201 in city state Signature of Authorized Officer or Agent Printed name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF 201. C. G*A. 36-60-6 stating affirmatively that the individual firm or corporation employs fewer than 100 employees and therefore is not required to register with/or utilize the federal work authorization program commonly known as E-Verify or any subsequent replacement program in accordance with the applicable provisions and deadlines established in O. C. G*A. 13-10-90. Signature of Exempt Private Employer Printed Name of Exempt Private Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on 201 in city state Signature of Authorized Officer or Agent Printed name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF 201.
Form preview Hire houston first application... Hire Houston First Application and Affidavit Thank you for your interest in the Hire Houston First initiative. Businesses interested in becoming eligible to participate in the Hire Houston First initiative must complete this application and sign the attached affidavit. It is the policy of the City of Houston as defined in Chapter 15 Article XI to use the City s spending powers in a manner that promotes fiscal responsibility and maximizes the effectiveness of local tax dollars by ensuring a portion of citizens tax dollars remain in the local economy for economic benefit of the citizens by utilizing all available legal opportunities to contract with city and/or local businesses. Only businesses that meet the requirements will be eligible to participate in the Hire Houston First initiative. A completed HHF application is NOT evidence of designation under the Hire Houston First initiative. An applicant s eligibility must be confirmed in writing by the Office of Business Opportunity Definitions A. City Business means a business with a principal place of business within city limits. B. Local Area means the Houston-Sugar Land-Baytown metropolitan statistical area as defined by the Office of Management and Budget within the Executive Office of the President of the United States and includes the counties of Harris Fort Bend Montgomery Brazoria Galveston Chambers Waller Liberty Austin and San Jacinto. C. Local Business means a business with a principal place of business in the local area* D. Principal Place of Business means the business must be either 1 headquartered in the incorporated limits of the city or the local area as applicable or 2 have an established place or places of business in the incorporated limits of the city or the local area from which 20 or more of the entity s workforce are regularly based and from which a substantial role in the entity s performance of a commercially useful function or a substantial part of its operations is conducted* A location utilized solely as a post office box mail drop or telephone message center or any combination thereof with no other substantial work function shall not be construed as a Principal Place of Business. E* Headquartered means the location where an entity s leadership directs controls and coordinates the entity s activities. Please complete the following form/affidavit and submit it to the Office of Business Opportunity Houston Business Solutions Center located at 611 Walker Lobby Level and Houston TX 77002 832 393-0954. Applications may be submitted via e-mail to houstonBSC houstontx. gov or faxed to 832. 393. 0650. Incomplete applications and affidavits will not be processed* Please answer all questions. / Application Date Company is applying as Check at least one City Business CB with a principal place of business within the city limits from which a substantial role in the entity s performance of a commercially useful function or a substantial part of its operations is conducted as defined in Chapter 15 Article XI.
Form preview The home depot inc insurance a... Dept. THE HOME DEPOT, INC. INSURANCE APPROVAL REQUEST FORM Supplier Name: Supplier Telephone: Supplier Number Supplier Contact Name: Supplier Fax: Agent/Broker: Agent/Broker Telephone: Supplier Email:
Form preview City of houston annual update... http://www.houstontx.gov/obo/index.html. Submit Completed Application Package to: City of Houston. Office of Business Opportunity. 611 Walker, 7th Floor.

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