ACCEPTED AND AGREED TO BY Sample Clauses
ACCEPTED AND AGREED TO BY. ▇▇▇▇▇▇ ▇▇▇▇▇
ACCEPTED AND AGREED TO BY. LICENSEE:
ACCEPTED AND AGREED TO BY. Reseller’s Full Legal Name
ACCEPTED AND AGREED TO BY. SOUTHERN NEVADA ANTHROPOMORPHIC EVENTS ALEXIS PARK ALL SUITE RESORT ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Convention Chair Sales Manager Signature Signature Date Date ALEXIS PARK ALL SUITE RESORT ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Director of Sales Signature Date
ACCEPTED AND AGREED TO BY. BRAINSWAY LTD. The following signature(s) are made subject to receipt of all necessary approvals (including of the Board of Directors and Shareholders) and satisfaction of all corporate policies and procedures.
ACCEPTED AND AGREED TO BY. Oncternal Therapeutics, Inc. The University of Texas M. D. ▇▇▇▇▇▇▇▇ Cancer Center
ACCEPTED AND AGREED TO BY. AEP Span, a Division of ASC Profiles Inc. Original Owner:
ACCEPTED AND AGREED TO BY. (Telephone Company Authorized Representative) ---------------------------- (Name of Telephone Company) EXHIBIT D State Administrators -------------------- California Department of Corporations ---------- ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Hawaii Director of Commerce and Consumer Affairs ------ ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Honolulu, HI 96813 ▇▇▇-▇▇▇-▇▇▇▇ Illinois Illinois Attorney General's Office -------- ▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Indiana Indiana Secretary of State ------- 302 ▇. ▇▇▇▇▇▇▇▇▇▇ Street, Room E-111 ▇▇▇▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Maryland Office of the Attorney General -------- Division of Securities ▇▇▇ ▇▇. ▇▇▇▇ ▇▇▇▇▇▇, 20th Floor Baltimore, MD 21202-2020 ▇▇▇-▇▇▇-▇▇▇▇ Michigan Department of the Attorney General -------- Consumer Protection Division Franchise Section ▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Minnesota Office of the Commissioner of Commerce --------- Department of Commerce ▇▇▇ ▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇. ▇▇▇▇, MN 55101 ▇▇▇-▇▇▇-▇▇▇▇ New York New York State Department of Law -------- Bureau of Investor Protection and Securities ▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇▇▇ ▇▇▇▇▇ ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ State Administrators --------------------- (continued) ----------- North Dakota Securities Commissioner ------------ ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Oregon Department of Consumer and Business Services ------ Division of Finance and Corporate Securities Labor and Industries ▇▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Rhode Island Department of Business Regulation ------------ ▇▇▇▇▇ ▇▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ South Dakota Division of Securities ------------ ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Virginia Division of Securities and Retail Franchising -------- Director, State Corporation Commission ▇▇▇▇ ▇. ▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Washington Department of Financial Institutions ----------- Securities Division ▇.▇. ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Wisconsin Office of the Commissioner of Securities --------- ▇.▇. ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ EXHIBIT E Agents Authorized to Receive Service of Process ----------------------------------------------- California Commissioner of Corporations ---------- Department of Corporations ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇., ▇▇▇ ▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Hawaii Director of Department of Commerce and Consumer Affairs ------ ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Honolulu, HI 96813 Illinois...
ACCEPTED AND AGREED TO BY. WACYPAA 15 WACYPAA 15 ▇▇. ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇. ▇▇▇▇ ▇▇▇▇▇▇▇ ALEXIS PARK RESORT ALEXIS PARK RESORT
ACCEPTED AND AGREED TO BY. Name of Agent - Business Entity or Individual Name (please print) Signature of Agent or Authorized Officer, if Bueiness Entity Date Name of Upline - Business Entity or Indiviudal Name (please print) Title Signature of Upline or Authorized Officer, if Bueiness Entity Date Prosperity Life Group is a trade name representing various affiliates of the Prosperity Life Insurance Group, LLC, including the operating members listed above. Members not licensed in all states. Only SBLI USA Life Insurance Company, Inc. is licensed in New York. Each member is solely responsible for its financial condition and contractual obligations. APTCAAECW16 Page 1 of 1 7/2016 SBLI USA Life Insurance Company, Inc. S.USA Life Insurance Company, Inc. Shenandoah Life Insurance Company (Each the “Company”) This form is used to enable the Agent to designate a beneficiary to receive money due the Agent from the Company after the death of the Agent. Unless this form is completed and received by the Company prior to the Agent’s death, money due the Agent posthumously under the contract shall be paid in the following order of preference: