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Declaration regarding notice f... ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME, AND ADDRESS): FOR COURT USE ONLY BAR NO: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE Street Address: Mailing Address: City &

Declaration concerning debtors... B6 Declaration (Official Form 6 - Declaration) (12/07) In re , Debtor Case No. (if known) DECLARATION CONCERNING DEBTOR'S SCHEDULES DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR I declare

California license and certifi... ACCORDANCE WITH THE LAWS OF THE STATE OF CALIFORNIA AS INDICATED BELOW. 26A. DATE OF ... OF VITAL RECORDS. VS-116 (01/01/ 2010) ... The completion of all items requested on this form is mandatory.

50 244 dealeramp39s motor vehi... CONFIDENTIAL Dealer's Motor Vehicle Inventory Declaration Year Form 50-244 P r o p e r t y Ta x Send Original to: Appraisal District Name and Address Send Copy to: County Tax Office and Address Phone

Declaration value form STATE OF NEVADA DECLARATION OF VALUE FORM 1. Assessor Parcel Number s a 2. Type of Property a Vacant Land b Single Fam. Res. FOR RECORDER S OPTIONAL USE ONLY c Condo/Twnhse d 2-4 Plex Book Page e Apt. Bldg f Comm l/Ind l Date of Recording g Agricultural h Mobile Home Notes Other 3. Total Value/Sales Price of Property Deed in Lieu of Foreclosure Only value of property Transfer Tax Value Real Property Transfer Tax Due 4. If Exemption Claimed a* Transfer Tax Exemption per NRS 375. 090 Section b. Explain Reason for Exemption 5. Partial Interest Percentage being transferred The undersigned declares and acknowledges under penalty of perjury pursuant to NRS 375. 060 and NRS 375. 110 that the information provided is correct to the best of their information and belief and can be supported by documentation if called upon to substantiate the information provided herein* Furthermore the parties agree that disallowance of any claimed exemption or other determination of additional tax due may result in a penalty of 10 of the tax due plus interest at 1 per month. Pursuant to NRS 375. 030 the Buyer and Seller shall be jointly and severally liable for any additional amount owed* Signature Capacity SELLER GRANTOR INFORMATION REQUIRED Print Name Address City State Zip BUYER GRANTEE INFORMATION COMPANY/PERSON REQUESTING RECORDING required if not seller or buyer Escrow AS A PUBLIC RECORD THIS FORM MAY BE RECORDED/MICROFILMED. Bldg f Comm l/Ind l Date of Recording g Agricultural h Mobile Home Notes Other 3. Total Value/Sales Price of Property Deed in Lieu of Foreclosure Only value of property Transfer Tax Value Real Property Transfer Tax Due 4. If Exemption Claimed a* Transfer Tax Exemption per NRS 375. 090 Section b. Explain Reason for Exemption 5. If Exemption Claimed a* Transfer Tax Exemption per NRS 375. 090 Section b. Explain Reason for Exemption 5. Partial Interest Percentage being transferred The undersigned declares and acknowledges under penalty of perjury pursuant to NRS 375. Partial Interest Percentage being transferred The undersigned declares and acknowledges under penalty of perjury pursuant to NRS 375. 060 and NRS 375. 110 that the information provided is correct to the best of their information and belief and can be supported by documentation if called upon to substantiate the information provided herein* Furthermore the parties agree that disallowance of any claimed exemption or other determination of additional tax due may result in a penalty of 10 of the tax due plus interest at 1 per month. 060 and NRS 375. 110 that the information provided is correct to the best of their information and belief and can be supported by documentation if called upon to substantiate the information provided herein* Furthermore the parties agree that disallowance of any claimed exemption or other determination of additional tax due may result in a penalty of 10 of the tax due plus interest at 1 per month. Pursuant to NRS 375. 030 the Buyer and Seller shall be jointly and severally liable for any additional amount owed* Signature Capacity SELLER GRANTOR INFORMATION REQUIRED Print Name Address City State Zip BUYER GRANTEE INFORMATION COMPANY/PERSON REQUESTING RECORDING required if not seller or buyer Escrow AS A PUBLIC RECORD THIS FORM MAY BE RECORDED/MICROFILMED.

Gc 335 form GC-335 ATTORNEY OR PARTY WITHOUT ATTORNEY Name State Bar number and address FOR COURT USE ONLY FAX NO. Date TYPE OR PRINT NAME SIGNATURE OF DECLARANT Page 1 of Form Adopted for Mandatory Use Judicial Council of California GC-335 Rev. January 1 2004 Probate Code 811 813 1801 1825 1881 1910 2356. Optional TELEPHONE NO. E-MAIL ADDRESS Optional ATTORNEY FOR Name SUPERIOR COURT OF CALIFORNIA COUNTY OF STREET ADDRESS MAILING ADDRESS CITY AND ZIP CODE BRANCH NAME CONSERVATORSHIP OF THE PERSON CONSERVATEE ESTATE OF Name PROPOSED CONSERVATEE CASE NUMBER CAPACITY DECLARATION CONSERVATORSHIP TO PHYSICIAN PSYCHOLOGIST OR RELIGIOUS HEALING PRACTITIONER The purpose of this form is to enable the court to determine whether the proposed conservatee check all that apply is able to attend a court hearing to determine whether a conservator should be appointed to care for him or her. The court A. Complete item 5 sign and file page 1 of this form* hearing is set for date has the capacity to give informed consent to medical treatment. Complete items 6 through 8 sign page 3 and file pages 1 B. through 3 of this form* has dementia and if so 1 whether he or she needs to be placed in a secured-perimeter residential care facility for the C. elderly and 2 whether he or she needs or would benefit from dementia medications. Complete items 6 and 8 of this form and form GC-335A sign and attach form GC-335A. File pages 1 through 3 of this form and form GC-335A. If more than one item is checked above sign the last applicable page of this form or form GC-335A if item C is checked* File page 1 through the last applicable page of this form also file form GC-335A if item C is checked* COMPLETE ITEMS 1 4 OF THIS FORM IN ALL CASES* GENERAL INFORMATION 1. Name 2. Office address and telephone number 3. I am a*. physician psychologist acting within the scope of my licensure a California licensed with at least two years experience in diagnosing dementia* b. an accredited practitioner of a religion whose tenets and practices call for reliance on prayer alone for healing which religion is adhered to by the proposed conservatee. The proposed conservatee is under my treatment. Religious practitioner may make the determination under item 5 ONLY. 4. Proposed conservatee name a* I last saw the proposed conservatee on date b. The proposed conservatee is is NOT a patient under my continuing treatment. ABILITY TO ATTEND COURT HEARING 5. A court hearing on the petition for appointment of a conservator is set for the date indicated in item A above. Complete a or b. Because of medical inability the proposed conservatee is NOT able to attend the court hearing check all items below that apply on the date set see date in box in item A above. for the foreseeable future. until date and state the facts in Attachment 5 Supporting facts State facts in the space below or check this box I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 5 ESTATE OF Name 6. EVALUATION OF PROPOSED CONSERVATEE S MENTAL FUNCTIONS Note to practitioner This form is not a rating scale.

To change the coverage that is... to change the coverage that is listed on your Declarations page you may use this form to do so. UNINSURED/UNDERINSURED MOTORISTS BODILY INJURY ...

Fsc declared form Self-Declaration regarding FSC-POL-01-004. (Policy for the Association of Organizations with FSC). The signing Organization is associated with the Forest ...

Archdiocese of galveston houst... Archdiocese of Galveston-Houston PETITION for a DECLARATION of NULLITY Due to LACK of CANONICAL FORM (Canon 1117) (This petition is to be completed only by the Case Sponsor.) This petition is used

32 2501 form Teletype TTY users may use the Washington Relay Service by calling 711. REV 32 2501 07/12/13 Print This Form Reset This Form. Washington State Department of Revenue Compliance Procedures Admin* PO Box 47473 Olympia WA 98504-7473 Declaration of Buyer and Seller Regarding Value of Used Vehicle Sold THIS FORM MUST BE COMPLETED ENTIRELY IN ORDER TO BE VALID Description of vehicle Make Model Year Vehicle Identification Number Seller s Name s please print Address City Phone State Zip Buyer s Name s please print Amount Paid Date of Sale / Describe condition of vehicle example needs new engine bodywork etc* Washington law Chapter 82. 12 RCW imposes a use tax on vehicles purchased from persons who are not required to collect the retail sales tax. The tax is due from the buyer on the value of the vehicle at the time of first use. RCW 82. 12. 010 7 a defines value of the article used for use tax purposes. Value means the amount paid or contracted to be paid for the vehicle. If the purchase price does not represent the true value of the vehicle acquired the value is to be determined as nearly as possible according to the retail selling price at place of use of similar vehicle s of like quality and character. The Department of Revenue may based on this statutory provision review and audit declarations of buyers and sellers regarding value of used vehicles sold with possible additional tax interest and penalties as a result* The following statements are made under the laws of the State of Washington* Indicate the city and state for place signed* I declare under penalty of perjury that the above amount is the total amount paid or contracted to be paid for the described vehicle. Seller s Signature Buyer s Signature Date Place Signed For tax assistance or to request this document in an alternate format please call 1-800-647-7706. Washington State Department of Revenue Compliance Procedures Admin* PO Box 47473 Olympia WA 98504-7473 Declaration of Buyer and Seller Regarding Value of Used Vehicle Sold THIS FORM MUST BE COMPLETED ENTIRELY IN ORDER TO BE VALID Description of vehicle Make Model Year Vehicle Identification Number Seller s Name s please print Address City Phone State Zip Buyer s Name s please print Amount Paid Date of Sale / Describe condition of vehicle example needs new engine bodywork etc* Washington law Chapter 82. 12 RCW imposes a use tax on vehicles purchased from persons who are not required to collect the retail sales tax. 12 RCW imposes a use tax on vehicles purchased from persons who are not required to collect the retail sales tax. The tax is due from the buyer on the value of the vehicle at the time of first use. RCW 82. 12. 010 7 a defines value of the article used for use tax purposes. The tax is due from the buyer on the value of the vehicle at the time of first use. RCW 82. 12. 010 7 a defines value of the article used for use tax purposes. Value means the amount paid or contracted to be paid for the vehicle. If the purchase price does not represent the true value of the vehicle acquired the value is to be determined as nearly as possible according to the retail selling price at place of use of similar vehicle s of like quality and character.

Florida living will declaratio... Declaration, made this day of ,20 I, willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and do hereby declare that,

Form 805 Rule 8.05 Financial Statement EXHIBIT 'A' IN THE CHANCERY COURT OF COUNTY, MISSISSIPPI V. PLAINTIFF CAUSE NUMBER: DEFENDANT ************************************************************************************************************************

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