Authorized Representative Information Sample Clauses
The Authorized Representative Information clause identifies the individuals or entities who are officially designated to act on behalf of a party in matters related to the agreement. This clause typically requires each party to provide the names and contact details of their authorized representatives, and may specify the scope of their authority, such as signing documents or making binding decisions. By clearly establishing who is empowered to represent each party, the clause helps prevent misunderstandings and ensures that communications and actions are legally valid and recognized.
Authorized Representative Information. □ Mr. □ Mrs. □ Ms. □ Miss □ Dr. □ Other Name (First / Middle / Last) Social Security Number Date of Birth (mm/dd/yyyy) Home/Legal Street Address City, State, Zip Code Country (if not United States) Mailing Address (if different from above) Telephone Number Telephone Number Home Cellular Business Home Cellular Business Email Address Country of Citizenship Country of Permanent Residency Method of delivery: □ Electronic correspondence: Tax Letter, Grant Confirmation Letters, Statements and other Documents. □ Paper correspondence: Tax Letter, Statements and other Documents. □ Mr. □ Mrs. □ Ms. □ Miss □ Dr. □ Other Name (First / Middle / Last) Social Security Number Date of Birth (mm/dd/yyyy) Home/Legal Street Address City, State, Zip Code Country (if not United States) Mailing Address (if different from above) Telephone Number Telephone Number Home Cellular Business Home Cellular Business Email Address Country of Citizenship Country of Permanent Residency Method of delivery: □ Electronic correspondence: Tax Letter, Grant Confirmation Letters, Statements and other Documents. □ Paper correspondence: Tax Letter, Statements and other Documents. Occupation (See below for examples) Occupation Examples: Accounting/Auditing, Admin/Clerical, Attorney/Arbitrator/Paralegal, Banking Professional, Car/Boat/Airplane Dealer, Casino/Gaming, Construction/Skilled Trades, Creative/Design/Architectural, Defense/Military, Doctor/Medical/Health, Editorial/Writing/Publishing, Education, Engineering/Science/R & D, Entertainment/ Sports/Arts, Homemaker, Hospitality/Food, Independent Investor, Information Technology, Insurance, Manufacturing/Production Operations, Non-Bank Financial Professional (security broker/investment adviser/private equity or hedge fund professional), Not for Profit Executive, Public Service/ Elected Official/ Embassy, Real Estate /Leasing, Retail/Art Dealer/Antiques, Student, Transportation/Warehousing, Unemployed, Retired, Other (requires explanation)* Place of Employment Dates of Employment *For Unemployed, Retired, or Other, please provide Prior Place of Employment and Dates of Employment Source of Wealth (See below for examples) Source of Wealth Examples : Business Profits, Distribution from 401(k), Divorce, Inheritance/Gift, Insurance Settlement, Law Suit, Salary, Sale of Business, Wealth Accumulation Over Time, Other (requires explanation) Details of Source of Wealth (i. e. salary from management position at ABC business): Source of Income (See below for ex...