Office Telephone Number Clause Samples

Office Telephone Number. Registrar's Office e-mail address Signature Date

Office Telephone Number. No. Faksimili Swasta Wiraswasta Ibu RT Profesional Peg. Negeri Peg. BUMN Mahasiswa Lainnya, sebutkan Tahun Kantor Sebelumnya Tahun Kode Pos Penghasilan Per Tahun Daftar Kekayaan/List of Assets Rumah, Lokasi Nilai Jual Objek Pajak (NJOP) Deposit Bank Jumlah Lainnya aaSn/ Filledpby theeCompacny custiommer only en Khusus diisi untuk nasabah perusah Antara Rp 100 - Rp 250 juta Between IDR 100 – IDR 250 millions Di atas Rp 500 juta Antara Rp 250 –Rp 500 juta Between IDR 250 – IDR 500 millions Nama Perusahaan Alamat Perusahaan Negara Asal No. Telepon

Office Telephone Number. No. Faksimili

Office Telephone Number. Physician Signature

Office Telephone Number. No. Faksimili Kode Pos Swasta Wiraswasta Ibu RT Profesional Peg. Negeri

Office Telephone Number. ( ) -------------------------------

Office Telephone Number. Occupation ....................................................................................................................................................

Office Telephone Number. Fax Number Are you a member of any one of the following please specify IATA /IATO/ TAAI / ADTOI/ Any other. Web site Address ( if any) Bank Accounts name & Account Number Bank Name,Branch & City PAN NUMBER (Mandatory) (Please attach the copy of pan card) Please mention in case ,the above pan number is in company’s name or Individuals name Tin Number (optional) SWIFT /RTGS/ IFSC ▇▇▇▇ Name Designation Mobile Number Phone number Email ID : Fax number Kindly note that all the incentives /Refund cheque will be issued /credited as per the details mentioned in the Bank Account section.

Office Telephone Number. Mailing Address ______________________________________ City, State, Zip Code ______________________________________ State of Residence ______________________________________ Social Security/Tax ID No. ______________________________________ Date $550 Sales Price per Unit -------------------------------------- ____________________ Number of Units to be sold ======================================== ------- FOR INTERNAL USE ONLY ------- ACCEPTED: KALMIA INVESTORS, LLC By: Smithtown Bay, LLC Its Manager By: Global Capital Management, Inc. Its Manager By: /s/ --------------------- Name: Michael J. Frey Title: Chief Executive Officer =========================================== YOU MUST MAIL EXECUTED ORIGINAL TO THE PURCHASER: Kalmia Investors, LLC 601 Carlson Parkway, Suite 200 Minnetonka, MN 55305 PLEASE CALL ▇▇ ▇▇ (▇▇▇) ▇▇▇-0854 IF YOU HAVE ANY QUESTIONS REGARDING THE SALE OF YO▇▇ ▇▇▇▇▇ ================================================================================ INSTRUCTIONS TO COMPLETE AGREEMENT OF SALE