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Declaration card canada form Declaration Card ? For Agency Use Only ? U.S. V OV Cr PAX R Instructions All travellers must be identified on a Canada Border Services Agency (CBSA) Declaration Card. You may list up to four people

Form dlq 003 ATTORNEY, ATTORNEY DESIGNEE, OR PARTY WITHOUT ATTORNEY (name and address): Attorney Or Attorney Designee for (Client?s Name): Telephone No.: Fax No.: SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES

Cmv form 1 CMV FORM 1 Application cum-declaration as to the physical fitness 1. Name of the applicant 2. Son/ wife/ daughter of 3. 2 This declaration is to be submitted invariably with Medical Certificate in Form 1-A. ------------------ CMV Form 1-A Medical Certificate To be filled in by a registered medical practitioner appointed for the purpose by the State Government or person authorised in this behalf by the State Government referred to under sub-section 3 of Section 8 3. Permanent address 4. Temporary address Official address if any 5. a Date of birth b Age on date of application 6. Identification marks Declaration a Do you suffer from eplipsy or from sudden attacks of loss of consciousness or giddiness from any cause Yes / No b Are you able to distinguish with each eye or if you have held a driving license to drive a motor vehicle for a period of not less than five years and if you have lost the sight of one eye after the said period of five years and if the application is for driving a light motor vehicle other than a transport vehicle fitted with an outside mirror on the steering wheel side or with one eye at a distance of 25 metres in good day light with glasses if worn a motor car number plate c Have you lost either hand or foot or are you suffering from any defect in movement control or muscular power of either arm or leg d Can you readily distinguish the pigmentary colours red and green f Are you so deaf as to be unable to hear and if the application is for driving a light motor vehicle with or without hearing aid the ordinary sound signal likely to cause your driving of a motor vehicle to be a source of danger to the public if so give details. I hereby declare that to the best of my knowledge and belief the particulars give above and the declaration made therein are true. Signature or thumb impression Note 1 An applicant who answers Yes to any of the questions a c e f and g or No to either of the questions b and d should amplify his answers with full particulars and may be required to give further information relating thereto. a Does the applicant to the best of your judgment suffer from any defect of vision If so has it been corrected by suitable spectacle b Can the applicant to the best of your judgment readily distinguish the pigmentary colours red and green c In your opinion is he able to distinguish with his eye sight at a distance of 25 metres in good day light a of deafness which would prevent his hearing the ordinary sound signals blindness f Has the applicant any defect or deformity or loss of member which would interfere with the efficient performance of his duties as a driver If so give your reasons in details. g. Optional a Blood group of the applicant if the applicant so desires that the information may be noted in his driving licence. b RH factor of the applicant if the applicant so desires that the Certificate of Medical Fitness I certify that i I have personally examined the applicant Shri/ Smt. /Kum. ii That while examining the applicant I have directed special attention to his / her distant vision iii While examining the applicant I have directed special attention to his / her hearing ability the conditions of the arms legs hands and joints of both extremities of the applicant and iv I have personally examined the applicant for reaction time side vision and glare recovery applicable in case of persons applying for a licence to drive goods carriage carrying goods of dangerous or hazardous nature to human life.

A filled export declaration fo... Republic of the Philippines Department of Trade and Industry DTI form EXPORT DECLARATION 2 Exporter TIN Office of the Declaration Declaration BOI PEZA CLARK Date 5 No. of Item SUBIC Export Declaration

Cl500 declaration of need form Email: credentials ctc.ca.gov Website: www.ctc.ca.gov State of California Commission on Teacher Credentialing Certification, Assignment and Waivers Division 1900 Capitol Avenue Sacramento, CA 95811-4213

Vehicle suitable for safe use... Vehicle Suitable for Safe Use Declaration 1 7 Registered Operator details NSW Driver licence/Customer number Equipment and Fittings What fittings and equipment are on this vehicle? Horn Amber rotating

Email id for a2 form flywire Form A2 Application cum Declaration (To be completed by the applicant) Application for drawal of foreign exchange I. Details of the applicant a. Name : b. Address: c. Account No : Bank Address: Branch

Oceb self declaration form cam... CAMBRIDGE AND NORTH DUMFRIES HYDRO INC. SELF DECLARATION FORM PLEASE RETURN THIS COMPLETED FORM TO: Mail: Cambridge and North Dumfries Hydro Inc. P. O. Box 1060, 1500 Bishop Street, Cambridge, ON

Nmc international travel decla... TRAVEL DECLARATION FORM for NMC members Your Medical Scheme membership entitles you to International Travel Insurance. This policy will insure you and your dependants as listed under your Medical Aid membership against emergency medical expenses that may be incurred while traveling abroad for trips of up to 90 days at a time. In order to activate this benefit please complete the form below. Once the form has been completed please fax to 264 61 287 6091 or email to enquiries methealth. com*na* A policy document confirming your emergency medical cover will be issued and sent to you. Please note Should you have any queries or in case of emergencies please contact the Travel Guard Chartis 24 hour emergency medical assistance call centre on 44 1273 739 274 or the South African number 27 11 525 3109 Application For International Emergency Medical Expenses Cover Scheme Membership Number Please complete main member dependant details below Title Firstname Lastname Date of birth Telephone No Fax No Email address Departure Date from home Return Date Return to home Countries to be visited House Doctor Name and tel Next of Kin Telephone number Passport Nr Please indicate with an asterisk to which e-mail/fax the Travel Protection Certificate must be sent Fax to. This policy will insure you and your dependants as listed under your Medical Aid membership against emergency medical expenses that may be incurred while traveling abroad for trips of up to 90 days at a time. In order to activate this benefit please complete the form below. Once the form has been completed please fax to 264 61 287 6091 or email to enquiries methealth. In order to activate this benefit please complete the form below. Once the form has been completed please fax to 264 61 287 6091 or email to enquiries methealth. com*na* A policy document confirming your emergency medical cover will be issued and sent to you. Please note Should you have any queries or in case of emergencies please contact the Travel Guard Chartis 24 hour emergency medical assistance call centre on 44 1273 739 274 or the South African number 27 11 525 3109 Application For International Emergency Medical Expenses Cover Scheme Membership Number Please complete main member dependant details below Title Firstname Lastname Date of birth Telephone No Fax No Email address Departure Date from home Return Date Return to home Countries to be visited House Doctor Name and tel Next of Kin Telephone number Passport Nr Please indicate with an asterisk to which e-mail/fax the Travel Protection Certificate must be sent Fax to. This policy will insure you and your dependants as listed under your Medical Aid membership against emergency medical expenses that may be incurred while traveling abroad for trips of up to 90 days at a time. In order to activate this benefit please complete the form below. Once the form has been completed please fax to 264 61 287 6091 or email to enquiries methealth. com*na* A policy document confirming your emergency medical cover will be issued and sent to you. Please note Should you have any queries or in case of emergencies please contact the Travel Guard Chartis 24 hour emergency medical assistance call centre on 44 1273 739 274 or the South African number 27 11 525 3109 Application For International Emergency Medical Expenses Cover Scheme Membership Number Please complete main member dependant details below Title Firstname Lastname Date of birth Telephone No Fax No Email address Departure Date from home Return Date Return to home Countries to be visited House Doctor Name and tel Next of Kin Telephone number Passport Nr Please indicate with an asterisk to which e-mail/fax the Travel Protection Certificate must be sent Fax to.

Statutory declaration form w45... STATUTORY DECLARATION Form W.45(A) (This form may take about 3 minutes to complete) I, ........................................................................................................................................

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