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Form preview Bc hydro underground declarati... CUSTOMER REFERENCE GUIDE - UNDERGROUND RESIDENTIAL SERVICES The Canadian Electrical Code specifies that the supply end of a service shall be installed in a location satisfactory to both the Electrical
Form preview Cayman islands customs forms s... CAYMAN ISLANDS Department ofFinance Development and DECLARATION CUSTOMS Everypassengeror the head of a familytravellingtogetheris requiredto give the following information: ''RNAME...... iii;;;;;ilii
Form preview Palm declaration form I am a bona fide resident of the State of Florida at the time of making this declaration. I formerly resided atin And the place or places if any where I maintain another or other place of abode are as follows Indicate street address city county and state of any other place or places of abode The name of my spouse and children if applicable are Indicate spouse s name and names of children under 18 years of age I understand the penalty for perjury is up to 5 years in State Prison. Florida Statute 837. 02 Declarant State of Florida County of Palm Beach The foregoing instrument was sworn subscribed before me this day of personally known to me or who has produced as identification. Deputy Clerk or Notary Public Revised 9/2008. DECLARATION OF DOMICILE This is my declaration of domicile in the State of Florida that I am filing this day in accordance and in conformity with Florida Statute 222. 17. I hereby declare that I reside in and maintain a place of Name abode at Street address City County State Zip Code Which place of abode I recognize and intend to maintain as my permanent home and if I maintain another place or places of abode in some other state or states I hereby declare that my abovedescribed residence and abode in the State of Florida constitutes my predominant and principal home and I intend to continue it permanently as such. I am a bona fide resident of the State of Florida at the time of making this declaration* I formerly resided atin And the place or places if any where I maintain another or other place of abode are as follows Indicate street address city county and state of any other place or places of abode The name of my spouse and children if applicable are Indicate spouse s name and names of children under 18 years of age I understand the penalty for perjury is up to 5 years in State Prison* Florida Statute 837. 02 Declarant State of Florida County of Palm Beach The foregoing instrument was sworn subscribed before me this day of personally known to me or who has produced as identification* Deputy Clerk or Notary Public Revised 9/2008. DECLARATION OF DOMICILE This is my declaration of domicile in the State of Florida that I am filing this day in accordance and in conformity with Florida Statute 222. 17. I hereby declare that I reside in and maintain a place of Name abode at Street address City County State Zip Code Which place of abode I recognize and intend to maintain as my permanent home and if I maintain another place or places of abode in some other state or states I hereby declare that my abovedescribed residence and abode in the State of Florida constitutes my predominant and principal home and I intend to continue it permanently as such. 17. I hereby declare that I reside in and maintain a place of Name abode at Street address City County State Zip Code Which place of abode I recognize and intend to maintain as my permanent home and if I maintain another place or places of abode in some other state or states I hereby declare that my abovedescribed residence and abode in the State of Florida constitutes my predominant and principal home and I intend to continue it permanently as such. I am a bona fide resident of the State of Florida at the time of making this declaration* I formerly resided atin And the place or places if any where I maintain another or other place of abode are as follows Indicate street address city county and state of any other place or places of abode The name of my spouse and children if applicable are Indicate spouse s name and names of children under 18 years of age I understand the penalty for perjury is up to 5 years in State Prison* Florida Statute 837.
Form preview Financial declaration for rest... My Name Address City, State, Zip Phone Email In the ? District ? Justice Court of Utah, County Court Address Prosecutorial Jurisdiction Financial Declaration for Restitution v. Case Number Defendant
Form preview Declaration form by the applic... Declaration Form by the Applicant D e t I hereby decla that I hav read the in are ve nstruction car refully and I have submitt ted all docum ments according to HAAD equirements. re will nsible for any delay that ma incur if I su ay ubmit an inco omplete applic cation or re-su ubmit any doc cuments at a I w be respon later stage. understand th completing the verifica hat ation process does not gua arantee obtaiining a licens if I do not meet HAAD se Iu cr riteria* Pe ersonal Deta ails Fu Name ull First Name Middle Name Last Nam me Signature Date d dd/mm/yyyy. re will nsible for any delay that ma incur if I su ay ubmit an inco omplete applic cation or re-su ubmit any doc cuments at a I w be respon later stage. understand th completing the verifica hat ation process does not gua arantee obtaiining a licens if I do not meet HAAD se Iu cr riteria* Pe ersonal Deta ails Fu Name ull First Name Middle Name Last Nam me Signature Date d dd/mm/yyyy.
Form preview Declaration facility form Declaration Form by the Sponsoring Facility We hereby declare that is applying for HAAD licensure under our sponsorship and that we undertake to comply with and fulfill the licensing requirements for the above mentioned healthcare professionals. Please note that by signing this application I acknowledged the responsibility held by our facility to ensure that all information given to HAAD is true and correct Personal Details Full Name First Name Middle Name Last Name Official Title/Position Signature Date dd/mm/yyyy.
Form preview 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 preview 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
Form preview 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.
Form preview 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
Form preview 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
Form preview 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

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