PLEASE PRINT OR TYPE Sample Clauses

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PLEASE PRINT OR TYPE. Use a separate registration form for each camper. Favor de escribir con letra de molde y a maquina. ▇▇▇▇▇ una forma por cada participante.
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PLEASE PRINT OR TYPE. New Student ( ) Re-Entry Student ( ) Applicant Legal Name: (First) (Middle) (Last) Social Security #: - - Date of Birth: Driver’s License #: Home Telephone: ( ) - Work: ( ) - Cell: ( ) Address: City_ State Zip E-Mail Fax No.
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PLEASE PRINT OR TYPE. Property Owner:
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PLEASE PRINT OR TYPE. Name of Firm
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PLEASE PRINT OR TYPE. Princeton Municipal Utilities Account Number(s) (9 digits)
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PLEASE PRINT OR TYPE. NAME OF ORGANIZATION: LIC NO.:
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PLEASE PRINT OR TYPE. Complete Section A only if the Agent is contracting with the Company as an individual (in which case, all Agent level compensation will be paid to the Agent as an individual). Complete Section B only if the Agent is a busi- ness entity and this contract is between the Company and such entity (in which case, all Agent level compensation will be paid to the entity unless the Agent completes a separate Agent contract as an individual with the Com- pany). SECTION A SECTION B Individual Agent Name (Print or Type) Signature of Agent Social Security Number Business Entity Name (Print or Type) Signature of Authorized Officer Name of Authorized Officer (Print or Type) Federal Tax Identification Number Name of Managing General Agent (MGA) or General Agent (GA) Signature of SBLI USA Life Insurance Company, Inc. Officer This contract shall take effect on and subsequent con- tract years shall begin with the anniversary of this date. Agent Number
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Related to PLEASE PRINT OR TYPE

  • Please Print Name: High School: Graduation Date:

  • ACCOUNTS SUBJECT TO ERISA The ERISA Rider is applicable to all Customers Under Section II of this Schedule A.

  • Contractor Personnel – Reference Checks The Contractor warrants that all persons employed to provide service under this Contract have satisfactory past work records indicating their ability to adequately perform the work under this Contract. Contractor’s employees assigned to this project must meet character standards as demonstrated by background investigation and reference checks, coordinated by the agency/department issuing this Contract.

  • Data Storage Where required by applicable law, Student Data shall be stored within the United States. Upon request of the LEA, Provider will provide a list of the locations where Student Data is stored.

  • citizens abroad Unless the circumstances described in the parenthetical in paragraph 1 above are applicable, either (a) at the time the buy order was originated, the buyer was outside the United States or we and any person acting on our behalf reasonably believed that the buyer was outside the United States or (b) the transaction was executed in, on or through the facilities of a designated offshore securities market, and neither we nor any person acting on our behalf knows that the transaction was pre-arranged with a buyer in the United States.