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Form 7507 2012 1 Not to be completed when passenger manifests are presented. CBP Form 7507 11/12 Notes and Specifications NOTE 1. DEPARTMENT OF HOMELAND SECURITY U*S* Customs and Border Protection GENERAL DECLARATION Outward/Inward AGRICULTURE CUSTOMS IMMIGRATION AND PUBLIC HEALTH OMB No* 1651-0002 Expires 02/28/2015 See back of form for Paperwork Reduction Act Notice. 19 CFR 122. 43 122. 52 122. 54 122. 73 122. 144 Owner or Operator Marks of Nationality and Registration Departure from Flight No* Date Arrival at Place FLIGHT ROUTING Place Column always to list origin every en-route stop and destination PLACE TOTAL NUMBER OF CREW NUMBER OF PASSENGERS ON THIS STAGE 1 Departure Place Embarking Through on same flight Arrival Place Disembarking NUMBER OF SED s AND AWB s SED s Declaration of Health Persons on board known to be suffering from illness other than airsickness or the effects of accidents as well as those cases of illness disembarked during the flight AWB s For official use only Any other condition on board which may lead to the spread of disease Details of each disinsecting or sanitary treatment place date time method during the flight. If no disinsecting has been carried out during the flight give details of most recent disinsecting Signed if required Crew Member Concerned I declare that all statements and particulars contained in this General Declaration SIGNATURE Authorized Agent or Pilot-in-Command and in any supplementary forms required to be presented with this General Declaration are complete exact and true to the best of my knowledge and that all through passengers will continue/have continued on the flight. An arrival-departure card CBP Form I-94 for each passenger on board shall be presented to the immigration officer at the port of first arrival* List surname given name and middle initial of each crew member in the column headed Total Number of Crew. Air cargo manifests shall be attached hereto. If copies of air waybills/consignment notes are attached their numbers shall be entered on separate cargo manifest CBP Form 7509 to be attached hereto. If copies of air waybills/ consignment notes are not attached to this form a separate cargo manifest CBP Form 7509 completed to show the full information required shall be furnished* If the airline or operator consolidates a shipment with other shipments or encloses the goods in other wrappers or containers either separately or with other goods the changes in packing and/ or marks and numbers must be clearly stated in the air way-bill/consignment note. This section is to be completed only as directed by the U*S* Centers for Disease Control and Prevention CDC in the event of a public health emergency. Conveyance operators should follow established procedures for reporting deaths/ill persons onboard an aircraft as required by 42 CFR Part 71. Third item-- If entry is duplicated it is to be a initialed by person signing the general declaration or b signed by his authorized agent having knowledge of measures applied* This General Declaration and/or attached manifests or air waybills should not bear erasures or corrections except those approved by the proper public authorities concerned nor contain interlineations or several listings on the same line.

8 010 2014 2019 form Childcare Expenses Paid for Joint Child ren 16. City Where Childcare is Provided Page 1 - FORM 8. 010. 5 UNIFORM SUPPORT DECLARATION OF PETITIONER RESPONDENT CO-PETITIONER CO-RESPONDENT OTHER UTCR 8. 010 4 8. 010 7 8. 040 3 8. 040 4 8. 050 1 8. 050 3 Revised 12-1-14 This form is a DECLARATION under penalty of perjury required for support determinations. 010 4 8. 010 7 8. 040 3 8. 040 4 8. 050 1 8. 050 3 Revised 12-1-14 This form is a DECLARATION under penalty of perjury required for support determinations. It must be completed in its entirety signed filed with the court or appropriate administrative agency and served upon the other party or their attorney. IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR COUNTY In the Matter of Petitioner Co-Petitioner and Respondent Co-Respondent. Case No* Judge Assigned Check one box PETITIONER S RESPONDENT S CO-PETITIONER S CO-RESPONDENTS or OTHER UNIFORM SUPPORT DECLARATION OR CSP Case No* SUMMARY INFORMATION COMPLETE THIS PAGE LAST After completing Sections 1 through 5 on Pages 2 through 5 below insert the information and/or total MONTHLY amounts in this Summary Information section* Date of Completion mm/dd/year 1. Number of Joint Children From This Relationship 3. Number of Nonjoint Additional Children 4. Gross Monthly Income From All Sources 5. Receiving Temporary Assistance for Needy Families Yes No 6. Child ren on Oregon Health Plan/Healthy Kids or Other Public Health Plan 7. Social Security or Veteran s Benefits Received for Child ren Person with Disability is Child Me Other Parent 8. Spousal Support RECEIVED by You 10. Mandatory Union Dues Paid 11. Health Care Premiums for Yourself 13. Out-of-Pocket Medical Expenses Paid for Joint Child ren 14. Number of ANNUAL Overnights Child ren Spends With You 15. 5 UNIFORM SUPPORT DECLARATION OF PETITIONER RESPONDENT CO-PETITIONER CO-RESPONDENT OTHER UTCR 8. It must be completed in its entirety signed filed with the court or appropriate administrative agency and served upon the other party or their attorney. INSTRUCTIONS Answer all questions. Items marked with an should be transferred to Page 1. If you are seeking spousal support you need to complete Schedule 1. Attach additional page if needed* IMPORTANT This information will be disclosed to the other party and may be subject to public access. Protections are available using the court s Confidential Information Form process. CHILDREN A. List all JOINT CHILDREN children under the age of 21 born or adopted during this relationship Children Living With Name of Child Age Me Other Parent Other Over 18 Under 21 Attending School Yes No B. List all NONJOINT ADDITIONAL CHILDREN children under the age of 21 born to or adopted by you but not of this relationship. Name YOUR GROSS INCOME A. From Your Employment Description Monthly Amount Gross hourly wage. Average number of hours worked per pay period. x Convert to annual* If paid monthly enter 12. If paid twice monthly enter 24. Every two weeks enter 26.

Texas form declaration 2015 P r o p e r t y Ta x Dealer s Motor Vehicle Inventory Declaration Form 50-244 CONFIDENTIAL Year Send Original to Appraisal District Name and Address Phone area code and number Send Copy to County Tax Office and Address This document must be filed with the appraisal district office and the county tax assessor-collector s office in the county in which your business is located. Do not file this document with the office of the Texas Comptroller of Public Accounts. Location and address information for the appraisal district office in your county may be found at comptroller. texas. gov/propertytax/references/directory/cad* Location and address information for the county tax assessor-collector s office in your county may be found at comptroller. texas. gov/propertytax/references/directory/tac* GENERAL INSTRUCTIONS This declaration is for a dealer of motor vehicles to declare motor vehicle inventory pursuant to Tax Code Section 23. 121. File a declaration for each business location* ALTERNATIVE ELECTION Effective Jan* 1 2014 certain dealers of motor vehicle inventory may elect to file renditions under Tax Code Chapter 22 rather than file declarations and tax statements under Tax Code Chapter 23. Tax Code Section 23. 121 a 3 allows a dealer to make this election if it 1 does not sell motor vehicles that are self-propelled and designed to transport persons or property on a public highway 2 meets either of the following two requirements a the total annual sales from the inventory less sales to dealers fleet transactions and subsequent sales for the preceding tax year are 25 or less of the dealer s total revenue from all sources during that period or b the dealer did not sell a motor vehicle to a person other than another dealer during the preceding tax year and the dealer estimates that the dealer s total annual sales from the dealer s motor vehicle inventory less sales to dealers fleet transactions and subsequent sales for the 12-month period corresponding to the current tax year will be 25 or less of the dealer s total revenue from all sources during that period 3 files with the chief appraiser and the tax collector by Aug. 31 of the tax year preceding Jan* 1 on a form prescribed by the Comptroller a declaration that the dealer elects not to be treated as a dealer under Tax Code Section 23. 121 in the current tax year AND 4 renders the dealer s motor vehicle inventory in the current tax year by filing a rendition with the chief appraiser in the manner provided by Tax Code Chapter 22. A dealer who makes this election must file the election annually with the chief appraiser and the tax collector by Aug. 31 of the preceding tax year so long as the dealer meets the eligibility requirements of law. WHERE TO FILE Each declaration must be filed with the county appraisal district s chief appraiser and a copy of each declaration must be filed with the collector. DECLARATION DEADLINES Except as provided by Tax Code Section 23. 122 l a declaration must be filed not later than Feb.

Transfer tax form 10677068 ASSET TRANSFER TAX DECLARATION P. L 2007 Chapter 100 A5002 N.J.S.A. 54 50-38 New Jersey Division of Taxation Bulk Transfers Box 245 Trenton NJ 08695-0245 Party Information Seller s Name Seller s FID/EIN Purchaser s Name ACTUAL Date of Sale Business Type check one S-Corporation Partnership Form TTD This form may be reproduced Please print or type LLC Corporation Proprietor State of Formation Return type filed to report gain CBT PART NJ1040/1041 NJ1040NR TIN If a gain is declared Line 9 each intended K-1 recipient must complete a declaration. Number of K-1s Realty Location if applicable Block s Street Address Lot s City Calculation of Estimated Tax to nearest dollar State Zip See reverse side for specific line instructions. 1. Consideration / Selling Price 2. Settlement Charges Not to include Mortgage/Loan payoffs 3. Cost After Depreciation 4. Current Year Loss 5. NOL Carryover if allowable 6. IRC Section 1031 Exchange if applicable 7. Gain subtract lines 2 through 6 from line 1 8. Amount of Gain Deferred if applicable 9. Current Year Gain subtract line 8 from line 7 10. Share of Gain if K-1 multiply line 9 by percentage 11. Tax Rate from NJ-1040 Schedule not effective rate. 12. Estimated Tax on Gain Due line 10 multiplied by line 11 Will there be installment proceeds Yes No if yes give details on reverse side. Taxpayer s Declaration I declare that all the information on this declaration is correct. I am aware that if any of the foregoing information provided by me is knowingly false I am subject to punishment. Date Owner/Partner/Member Signature Print Title Rev 04-13 1. 3. 0 or assignee of business assets of any possible claim for State taxes. This directive includes all final business tax returns and payment. Procedure The estimated tax on the gain portion of the escrow to be held at closing is initially calculated by multiplying the gross consideration by the tax rate of the taxpayer. Upon completion of this declaration submission to and review by the Division the estimated tax on the gain portion of the escrow may be reduced appropriately. Upon closing of the transaction the escrow will be held by the transferee s attorney and the estimated tax on the gain portion of the escrow will be demanded by the Division to be applied to the appropriate tax type and year. A confirmation of receipt and the application of the estimated tax payment will be sent to the transferor s attorney. The taxpayer files their year end business tax return claims credit for the payment and pays any additional tax due. They may request a refund or credit if an overpayment exists. Specific Line Instructions for Estimated Tax Calculation Special Note Lines 1 through 9 establish gain* Line 10 assigns share. Line 1 Total sale price or consideration of all assets currently being transferred* Line 2 Total amount of settlement charges to transferor associated with this transaction* Line 3 If fully depreciated enter zero. Line 8 Calculate amount deferred based on installment or short term notes. Line 9 For NJ1065 filers If any member/partner is not an individual or if the number of nonresident member/partners exceeds five 5 stop here and attach the most current membership directory.

Hamilton county verified finan... Clear FINANCIAL DECLARATION LR29-FLOO-402.10 FORM 402 B STATE OF INDIANA COUNTY OF HAMILTON IN RE THE MARRIAGE OF: Petitioner, and Respondent. HUSBAND: Name: Address: Employer: Attorney: Address:

Declaration regarding administ... DECLARATION REGARDING ADMINISTRATION OF OATH AND CONFIRMATION OF IDENTITY AND SOCIAL SECURITY NUMBER In re: (Debtor s Name) Bankruptcy Case No. Date of telephonic or video conference appearance at

Missing receipt declaration be... MISSING RECEIPT DECLARATION When a receipt is lost or otherwise unavailable and all measures to obtain a copy have been exhausted, this Missing Receipt Declaration should be completed. It should be

Mt homestead form Return Document to: Name Mailing Address City, State, Zip Declaration of Homestead and , the undersigned, hereafter referred to as claimant(s), reside on and do hereby claim the following described

Declaration of trade name decl... Acrobat Reader 6.0 or higher is required to complete, save & submit this form. Filing Instructions Print Form Declaration of Trade Name Partnership Act I, Name of Declarant of Resident Address

Host declaration italy form To the Visa Office of the Consulate General of Italy in Philadelphia Host declaration I the undersigned. Date of birth Place of birth Nationality resident in. Prov/Region Address. No*. ZIP/Post code. tel*. occupation/profession. For Companies or Organizations only Commercial activity/Name Located in. Prov/Region. Address. No ZIP/Post code. tel*. Name of the Legal Guardian/Holder. Resident in Prov/Region. Am aware of the consequences envisaged by Art. 12. 1 of Legislative Decree 286 of 25 July 1998 Consolidated Text of provisions governing immigration and rules on the status of foreign nationals and subsequent amendments. with the present document declare that I wish to invite The foreign national. name surname For the period from to. date for reasons of. 1 that my relationship with the person in question is one of family / friendship / other specify. 2 that I know with certainty that the person in question in his/her own country is employed in the following occupation is not in employment and has the following means of support. 3 that I will cover the living expenses of the applicant during his/her stay 4 that I have the financial means and sufficient accommodation to accommodate the above-mentioned foreign national 5 optional that I have already made available on behalf of the above-mentioned person as financial guarantee and in the form of bank security the sum of. euros in the following bank Name of bank. branch no. address. If the visa application submitted by the foreign national is successful I 1 provide him/her with accommodation in my own home located in. address. no. ZIP/Post Code. tel. 2 assume any costs resulting from recourse to health or medical care or treatment by the foreign national where he or she does not have their own health-care cover insurance policy or bilateral agreement between Italy and their country of origin 3 notify the local police headquarters of the presence of the foreign national in my home no more than 48 hours from the time the foreign national enters Italian territory in accordance with Art. 7 of Legislative Decree 286/1998 and subsequent amendments. 4 ensure that the foreign national returns to his/her country of origin by the date envisaged by his/her entry visa in accordance with Art. 1 1 of Law 68 of 28 May 2007. Information I am aware of and consent that the data required by this application form are mandatory for the examination of the visa application and any personal data concerning me which appear on this form will be supplied to the relevant authorities of the Member State and processed by those authorities for purposes of a decision on my visa application* Such data will be entered into and stored in the Visa Information System VIS for a maximum period of five years during which it will be accessible to the visa authorities and the authorities competent for carrying out checks on visas at external borders and within the Member State immigration authorities in the Member States for the purposes of verifying whether the conditions for the legal entry into stay and residence on the territory of the Member States are fulfilled and to the authority of the Member State competent for the examination of asylum application* Under certain conditions the data will be also available to designated authorities of the Member States and to Europol for the purpose of the prevention detection and investigation of terrorist offences and other serious criminal offences.

Pre retirement transition leav... Secr tariat du Conseil du Tr sor du Canada Treasury Board of Canada Secretariat PROTECTED WHEN COMPLETED APPLICATION FOR PRE-RETIREMENT TRANSITION LEAVE Information on this form is used to assess requests for Pre-retirement Transition Leave in accordance with approved policies. It is protected by the provisions of the Privacy Act and should be stored in standard employee bank PSE 901. PART I - EMPLOYEE DATA Surname Print Given name / Initials Department Branch / Division / Section Personal Record Identifier Address PART II - APPLICATION Duration of leave arrangement max. 2 years FROM TO Please indicate days to be taken off Leave Period day / week or hours / week if non-standard I request a leave arrangement in accordance with the Pre-retirement Transition Leave Policy. I agree not to work for the federal Public Service during the above period of leave. I understand that once accepted by the deputy head or his or her delegated authority and once my leave arrangement is completed my resignation is irrevocable. Day Month Year I resign effective conditional upon my leave arrangement not being cancelled prior to the dates agreed to above. DATED AT THIS DAY OF YEAR. Employee signature PART III - APPROVAL D LEAVE ARRANGEMENT APPROVED From To D I certify that the employee meets the eligibility criteria Responsibility Centre Manager print name Date PART IV - ACCEPTANCE OF RESIGNATION I accept your conditional resignation upon completion of the leave arrangement as agreed to above. TBS 325-9E Rev* 1999-05-18 Signature of Deputy Head or Delegated Authority Once completed provide employee with a photocopy. It is protected by the provisions of the Privacy Act and should be stored in standard employee bank PSE 901. PART I - EMPLOYEE DATA Surname Print Given name / Initials Department Branch / Division / Section Personal Record Identifier Address PART II - APPLICATION Duration of leave arrangement max. PART I - EMPLOYEE DATA Surname Print Given name / Initials Department Branch / Division / Section Personal Record Identifier Address PART II - APPLICATION Duration of leave arrangement max. 2 years FROM TO Please indicate days to be taken off Leave Period day / week or hours / week if non-standard I request a leave arrangement in accordance with the Pre-retirement Transition Leave Policy. 2 years FROM TO Please indicate days to be taken off Leave Period day / week or hours / week if non-standard I request a leave arrangement in accordance with the Pre-retirement Transition Leave Policy. I agree not to work for the federal Public Service during the above period of leave. I understand that once accepted by the deputy head or his or her delegated authority and once my leave arrangement is completed my resignation is irrevocable. I agree not to work for the federal Public Service during the above period of leave. I understand that once accepted by the deputy head or his or her delegated authority and once my leave arrangement is completed my resignation is irrevocable. Day Month Year I resign effective conditional upon my leave arrangement not being cancelled prior to the dates agreed to above.

Statutory declaration of commo... Service Canada PROTECTED B (when completed) Personal Information Banks HRSDC PPU 116 and 146 STATUTORY DECLARATION OF LEGAL MARRIAGE Social Insurance Number SECTION A - TO BE COMPLETED BY THE APPLICANT

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