DECLARATION AND SIGNATURES Clause Samples

DECLARATION AND SIGNATURES. In consideration of the hire fee described in clause 2(D), the Village Hall agrees to permit the Hirer to use the premises (defined as the whole hall including the car park) for the purpose described in clause 2(A) for the period(s) described in clauses 2(B) and 2(C). The details inserted in clause 1 and the answers to the questions in clauses 2 and 3 are terms of this agreement. Signing this Hiring Agreement means that you also commit to clauses 5 and 6, covering all hiring conditions, any additional special conditions and the ‘Important Information for Hirers’. These documents are provided separately.

DECLARATION AND SIGNATURES. I have read and fully understand the foregoing Contract of Employment and I agree to abide by the terms of the contract and further warrant that all statements and representations which I have made to the Institute in application for this appointment are true and correct.

DECLARATION AND SIGNATURES. I am authorised to sign this Agreement on behalf of Arcare Pty Ltd

DECLARATION AND SIGNATURES. All Directors, Partners, Officers and Authorised Person must agree and sign below. I/ We acknowledge that I/we have received, read and understood the Somerset ▇▇▇▇▇ Partners Investment Adviser’s Disclosure Statements. Where a person is signing as an Attorney, an original certified copy of the Power of Attorney must be provided. The Attorney hereby certifies that they have not been given notice revoking the Power of Attorney (POA). By signing below and returning Part A of this Agreement to Somerset ▇▇▇▇▇ Partners (“SSP”), I/we agree to the provision to me/us by SSP of sharebroking and ancillary services on the Terms and Conditions set out in Part B of this Agreement, the Appendices hereto and agree to abide by those Terms and Conditions. Name of First Director/Partner/Officer/POA: Signature: Date: Name of Second Director/Partner/Officer/POA: Signature: Date: Name of Third Director/Partner/Officer/POA: Signature: Date: Name of Fourth Director/Partner/Officer/POA: Signature: Date: Name of Authorised Person: Signature: Date: SSP agrees to provide sharebroking and ancillary services on the Terms and Conditions set out in Part B of this Agreement, the Appendices hereto and agrees to abide by those Terms and Conditions. SSP Authorised Name: SSP Authorised Signatory: Date: ▇▇▇▇▇▇▇▇ ▇▇▇▇▇ Partners will retain the original copy of this Client Agreement. Please contact us on (▇▇) ▇▇▇ ▇▇▇▇ or ▇▇▇▇▇▇@▇▇▇▇▇▇▇▇.▇▇.▇▇ if you require a copy for your records.

DECLARATION AND SIGNATURES. I/We hereby apply for Shares in RE:CM Global Fund Limited ( the Fund ) as specified above and confirm that I/we agree with the terms of this Subscription Agreement, including the attached Notes, and to be bound by the Offering Memorandum dated 31 August 2010. I/We confirm that I am/we are 18 years of age or over, aware of the risks involved in investing in the Fund, and not a Prohibited Person (as defined in the Offering Memorandum) and am/are not acquiring Shares on behalf of, or for the benefit of, a Prohibited Person nor do I/we intend selling or transferring any Shares which I/we may purchase to any person who is a Prohibited Person. I/We confirm that I was/we were not in the United States at the time any Shares were offered to me/us or when I/we executed this Agreement, and I/we confirm that I/we are not US Persons, as defined hereto. I/We confirm that I am/we are not resident in the Island of Guernsey, Herm or Alderney and am/are not acquiring Shares on behalf of, or for the benefit of, a person who is resident in those Islands nor do I/we intend selling or transferring any Shares which I/we may purchase to any person who is a resident of the islands of Guernsey, Herm or Alderney. I/We agree to provide these confirmations to the Fund at such times as the Fund may request, and to provide on request such certifications, documents or other evidence as the Fund may reasonably require to substantiate such representations. I/We agree to notify the Fund immediately if I/we become aware that any of the confirmations are no longer accurate and complete in all respects and agree immediately either to sell or to tender to the Fund for redemption a sufficient number of Shares to allow the confirmation to be made. I/We having received and considered a copy of the Offering Memorandum and any Supplemental Memoranda hereby confirm that this subscription is based solely on the Offering Memorandum and any Supplemental Memoranda for the Fund current at the date of this subscription and the material contracts therein referred together (where applicable) with the most recent audited annual report of the Fund and that I/we are not relying on any representations made by other third parties. I/We confirm that we have completed either Section 1, 2 or 3 in relation to Prevention of Money Laundering and Terrorist Financing. The Administrator, the Manager and the Fund are each hereby authorised and instructed to accept and execute any instructions in respect of the Shares to wh...

DECLARATION AND SIGNATURES. All Applicants and Authorised Person must agree and sign below. I/We confirm that I/we have not been declined service by any other NZX Firm or been declared bankrupt.I/We confirm that the particulars supplied in the Schedule are correct and that I/we have read and understood this Agreement and agree to comply with it.The person identified as the additional Authorised Person has read, understood and agrees to comply with this Agreement and is authorised to operate the account on my/our behalf.I/We acknowledge that I/we have read the risk disclosures relevant to this account as set out in Part B of this agreement.Where a person is signing as an Attorney, an original certified copy of the Power of Attorney must be provided. The Attorney hereby certifies that they have not been given notice revoking the Power of Attorney (POA).By signing below and returning Part A of this Agreement to ▇▇▇▇▇▇▇▇ ▇▇▇▇▇ Partners (“SSP”), I/we agree to the provision to me/us by SSP of sharebroking and ancillary services on the Terms and Conditions set out in Part B of this Agreement, the Appendices hereto and agree to abide by those Terms and Conditions. Name of First Applicant/POA: Signature: Date: Name of Second Applicant/POA: Signature: Date: Name of Authorised Person: Signature: Date: SSP agrees to provide to the Account Holder(s) named above, sharebroking and ancillary services on the Terms and Conditions set out in Part B of this Agreement, the Appendices hereto and agrees to abide by those Terms and Conditions. SSP Authorised Name: SSP Authorised Signatory: Date: ▇▇▇▇▇▇▇▇ ▇▇▇▇▇ Partners will retain the original copy of this Client Agreement.Please contact us on (▇▇) ▇▇▇ ▇▇▇▇ or ▇▇▇▇▇▇@▇▇▇▇▇▇▇▇.▇▇.▇▇ if you require a copy for your records.

DECLARATION AND SIGNATURES. Terms that apply to this document. Before signing this document. What you agree to by signing this document. DIRECT DEBIT/DIRECT CREDIT SERVICE AGREEMENT Changes we can make. Changes you can make. What you should consider if you cancel your direct debit request. If you want to dispute any debited amount. What happens if a direct debit payment to us is due on a non business day? If a direct debit request is rejected. We may need to disclose information. How you can contact us. What you should consider about making a direct debit/direct credit request

DECLARATION AND SIGNATURES. I am authorised to sign this Agreement on behalf of FRESH HOPE CARE SIGNATURE PRINT NAME AND TITLE Address: Date: I am authorised to sign this Agreement as a nominated employee bargaining representative SIGNATURE PRINT NAME AND TITLE Address: Date: I am authorised to sign this Agreement as the nominated employee bargaining representative on behalf of the New South Wales Nurses and Midwives’ Association/ Australian Nursing and Midwifery Federation NSW Branch SIGNATURE PRINT NAME AND TITLE Address: Date: I am authorised to sign this Agreement as the nominated employee bargaining representative on behalf of the Health Services Union NSW Branch SIGNATURE PRINT NAME AND TITLE Address: Date 1st year 22.25 23.82 24.47 2nd year 23.18 24.77 25.45 Thereafter (experienced without Cert III) 24.41 25.08 25.77 1st Year (with Cert III) 23.67 24.50 25.17 Thereafter (with Cert III) 24.41 25.08 25.77 Team Leader 25.41 26.11 26.83 1st year 26.75 27.49 28.24 2nd year 27.33 28.08 28.85 3rd year 27.91 28.68 29.47 4th year 28.50 29.28 30.09 Thereafter 29.11 29.91 30.73 Level a 28.78 29.57 30.38 Level b – 1st year 29.38 30.19 31.02 Level b – 2nd year 30.02 30.85 31.69 Level b – 3rd year 31.46 32.33 33.21 1st year 33.60 34.52 35.47 2nd year 35.65 36.63 37.64 3rd year 37.82 38.86 39.93 4th year 40.14 41.24 42.38 Thereafter 42.59 43.76 44.96 Clinical Nurse Specialist 44.31 45.53 46.78 Clinical Nurse Educator 44.31 45.53 46.78 1st year 47.22 48.52 49.85 2nd year 48.54 49.87 51.25 3rd year 49.75 51.12 52.52 4th year 52.35 53.79 55.27 1st year 53.60 55.07 56.59 2nd year 54.70 56.20 57.75 3rd year 56.54 58.09 59.69 Clinical Nurse Consultant 52.35 53.79 55.27 Level 1 - 1st year 47.22 48.52 49.85 Level 1 - 2nd year 48.54 49.87 51.25 Level 2 49.75 51.12 52.52 Level 3 51.06 52.46 53.91 < 20 beds 49.54 50.90 52.30 20 – 75 beds 50.82 52.22 53.65 75 – 100 beds 51.99 53.42 54.89 100 – 150 beds 53.08 54.54 56.04 150 – 200 beds 54.70 56.20 57.75 < 25 beds 55.39 56.91 58.48 25 – 50 beds 58.65 60.26 61.92 50 – 75 beds 59.90 61.55 63.24 75 – 100 beds 61.16 62.84 64.57 100 – 150 beds 62.91 64.64 66.42 150 – 200 beds 65.03 66.82 68.66 Grade 1 22.56 23.18 23.82 Grade 2 – Year 1 – Thereafter 23.18 23.82 24.47 Grade 2 ‘Care’ (without Cert III) – Year 1 – Year 2 – Thereafter (experienced without Cert III) Grade 2 ‘Care’ (with Cert III) – Year 1 (with Cert III) – Thereafter (with Cert III) Grade 3 25.41 26.11 26.83 Grade 4 - Level 1 - Level 2 26.75 27.49 28.24 Grade 5 - From - To 31.08 31.93 32.81 1st year...

DECLARATION AND SIGNATURES