Professional legal forms

Aml program template form Anti-Money Laundering Policy Statement & Program Procedures Compliance and Supervisory Procedures for (Company Name) (Company Street Address) (Company City, State ZIP Code) I. Company Anti-Money

Louisiana conrad state 30 prog... LOUISIANA CONRAD STATE 30 PROGRAM SITE INFORMATION Name and Address of Practice Site Contact Name and Title E-mail Telephone Fax Attorney for Employer if applicable Telephone Number at Applying Practice Site Practice fax Employer s telephone Employer s fax Attorney for Physician name contact info Practice Type Public Non-profit For profit Employer s Medicaid ID Service Site Type FQHC RHC Ambulatory Care Clinic Employer s Medicare ID SBHC SR...

Artwork approval qoutes pdf fo... Proof Approval Form PLEASE REVIEW YOUR PROOF THOROUGHLY. This proof is furnished to you to check for typographical, spelling & grammatical errors or mistakes in layout. If the publication needs

Welcome policy application for... Reset Form Welcome Policy Application Form Previously Approved Parks Forestry Recreation This form is an application for the Welcome Policy only. / Unit Address City Province Home Telephone Postal code Ontario Work Telephone Cell Phone Spouse / Partner Children Proof of Current Total Family Income Please check all boxes that apply Social Assistance Ontario Works Notice of Assessment T4 Slips Pays Stubs 2 consecutive Employment Insurance Source s of Income include Drug Benefit Eligibility Card Ontario Disability Support Program Workers Compensation Benefits Letter from Social Agency or Religious Institution must state total family income Guaranteed Income Supplement GIS CPP / Disability Pension Annual GROSS Family Income I have completed this application form for the Welcome Policy and state that the information I have provided is to the best of my knowledge. I agree to accept financial responsibility for the program s myself and my family are registered in should my application be denied. Applicant s signature Date dd/mm/yyyy The personal information on this form is collected under the authority of the City of Toronto Act 2006 s. 136 c the Ministry of Tourism and Recreation Act 1990 s. 4 Clause 6 of Report No. 1 of the Economic Development and Parks Committee as confirmed by Council in By-law 442-1999 and of Bylaw 1319-2008. The information is used by Toronto Employment and Social Services to determine eligibility for financial assistance in the form of a fee waiver pursuant to Toronto s Welcome Policy to advise Toronto s Parks Forestry and Recreation Division if your eligibility has been determined and for aggregate statistical reporting. You will need to register separately for recreation programs www. toronto. ca/torontofun Access to Welcome Policy for eligible persons is determined by Council policy. You may call 416-338-2000 to complete a telephone application or mail a completed application along with photocopied supporting documents to City of Toronto Welcome Policy Application 55 John St* MAILROOM Toronto ON M5V 3C6. Please PRINT clearly Applicant Main contact Last name First name Date of Birth dd/mm/yyyy Male Female Apt. I agree to accept financial responsibility for the program s myself and my family are registered in should my application be denied* Applicant s signature Date dd/mm/yyyy The personal information on this form is collected under the authority of the City of Toronto Act 2006 s. 136 c the Ministry of Tourism and Recreation Act 1990 s. 4 Clause 6 of Report No* 1 of the Economic Development and Parks Committee as confirmed by Council in By-law 442-1999 and of Bylaw 1319-2008. The information is used by Toronto Employment and Social Services to determine eligibility for financial assistance in the form of a fee waiver pursuant to Toronto s Welcome Policy to advise Toronto s Parks Forestry and Recreation Division if your eligibility has been determined and for aggregate statistical reporting. Questions about this collection can be directed to the Parks Forestry and Recreation Manager Customer Service Toronto City Hall Fl* 1 100 Queen Street W* Toronto Ontario M5H 2N2 or call 416-392-1902.

Policy brief template form OCTOBER, 2009 ACCELERATING HIGH VALUE HEALTHCARE DELIVERY American healthcare is the most expensive in the world, yet its system still struggles with uneven quality, serious access gaps, and population

Pto policy sample form PAID TIME OFF (PTO) POLICY To provide work life balance for employees the Company, provides paid time off for full-time employees who work an average of 32 or more per week. Employees earn paid time

5196 application form Form No. 5196 Rev Application for First Loan in Respect of Policies Prior to 1-6-69 Date Address at which Loan Cheque should be sent To The Sr. 1/- Assignee Trustee DECLARATION TO BE COMPLETED WHEN BORROWER/S CANNOT READ ENGLISH I hereby declare that the contents of the above APPLICATION FOR LOAN Form No. 5196/5205 and the FORM OF RECEIPT FOR THE LOAN ADVANCE Form No. 5200 have been translated and explained by me to and further declare that he / she they fully understand s the meaning there of. Signature of the declarant INSTRUCTIONS If either or both the borrowers be non-English knowing or illiterate an English knowing person should be requested to complete the above declarations as also to give the English rendering of the signature. Divisional Manager Life Insurance Corporation of India Dear Sir Re Policy No* Please grant me / us advance of Rs. or maximum available by way of loan against the above policy on which I / We agree to pay interest at the rate of 10. 5 per annum compounding half yearly. I am / We are also agreeable to the following endorsement being placed on the policy viz ADVANCE S BY WAY OF LOAN WHEN GRANTED AGAINST THE SECURITY OF THE POLICY SHALL BE MADE BY THE CORPORATION ON THE FOLLOWING TERMS AND CONDITIONS 1 The Policy shall be assigned absolutely to and held by the Corporation their successors and assignees as security for the repayment of the advance s and of the interest thereon and of all expenses which may be incurred in connection therewith. 2 The advances shall NOT be paid within a period of six months from the date on which the relative loan settled* 3 Interest on the advance s shall be paid compounding half-yearly to the Corporation their successors and assignees at the rate to be specified by the Corporation in respect of each advance when the relative is made the first payment of interest to be made on the date of next Policy anniversary or on the date six months before the next policy anniversary whichever immediately follows the date on which the relative advance is made and every half-yearly thereafter. 4 When called upon repayment of the advance s with all interest which may be due thereon shall be made being given three months notice to that effect. 5 The Corporation their successors and assignees shall not be bound to accept payment of any of the advance s unless tendered in full* 6 In the event of failure to repay the advance s to repay the advance s when required or to pay interest on the date as hereinbefore mentioned or within one calendar month after each due date respectively the Policy shall be held without the necessity of any notice being given to be forfeited to the Corporation their successors and assignees and Corporation shall be entitled to apply the Surrender Value allowable in respect of the Policy in terms of their Regulation and condition in payment of the advance s interest and expenses the balance only shall become due and payable under the policy. 7 In case the policy shall mature or become a claim by death when the amount of the advance S or any Portion there of shall remain outstanding the Corporation shall be entitled to deduct such amount together with all interest upto the date of maturity or of death as the case may be from the policy moneys and the balance due and payable under the policy.

Memorial bench policy town of... TOWN OF FALMOUTH 59 Town Hall Square Falmouth, MA 02540 508-548-7611 / Fax: 508-457-2511 In response to active interest from family members and friends seeking to install memorial benches, or other,

Lambton college fee refund pol... STUDENT WIRE TRANSFER FORM DATE: TO: LAMBTON COLLEGE STUDENT NAME: STUDENT NUMBER: NOTE: If money is being deposited to anyone other than the student, please complete the Permission Form below: TO

Authorization for release of i... Georgia Department of Behavioral Health & Developmental Disabilities Name of Individual/Consumer/Patient/Applicant Social Security Number AND/OR Date of Birth AUTHORIZATION FOR RELEASE OF INFORMATION

Nada39s fair credit compliance... Fair Credit Compliance POLICY & PROGRAM Table of Contents Overview of Fair Credit Policy & Compliance Program Templates 1 Instructions for Completing Fair Credit Policy and Compliance Program

Eastbay return print form RETURN AND EXCHANGE INSTRUCTIONS Thank you for your purchase . We appreciate the oppor tunity to provide you with high quality products and excellent customer ser vice . For your convenience , if

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