Renewal of Manager s Certificate

Size: px
Start display at page:

Download "Renewal of Manager s Certificate"

Transcription

1 Applicatin fr Renewal f Manager s Certificate Sectin 219, Sale and Supply f Alchl Act 2012 General infrmatin: Yu must renew yur manager s certificate befre it expires. Once yur manager s certificate has expired, it cannt be renewed and yu will need t make an applicatin fr a new manager s certificate. Office Use Only If yu are currently emplyed as a duty manager, the applicatin shuld be filed with the District Licensing Cmmittee nearest t the licensed premises where yu wrk. If yu are nt currently emplyed as a duty manager, the applicatin shuld be filed with the District Licensing Cmmittee fr the district in which yu are currently living. Please nly submit this applicatin if yu are eligible in the Hamiltn City Cuncil district. Applicatin Checklist: Supprting dcuments yu need t prvide with yur applicatin: Applicatin fee: $ This is an applicatin fee and is nn-refundable after the applicatin is received by the Hamiltn City Cuncil. A written reference frm yur emplyer at the licensed premises at which yu are currently wrking. This shuld cnfirm yur emplyment n licensed premises, hw lng yu have wrked there and relevant duties. If yur manager s certificate was nt issued/renewed in the Hamiltn City district, yu must als prvide: A cpy f yur yur manager s certificate / mst recent ntice f renewal. A cpy f yur Licence Cntrller Qualificatin (LCQ) certificate and LCQ bridging test cmpletin certificate (if applicable) A cpy f yur CV/ resume and any ther evidence regarding character, suitability and training t supprt yur applicatin. If yu are nt a New Zealand citizen r permanent resident, yu must als prvide: Cpy f valid passprt Cpy f current visa Cpy f Drivers Licence (if applicable) If yu are applying fr the renewal f manager's certificate n behalf f smene else yu must als prvide: A cpy f the authrity t act as an agent f the applicant, signed by the applicant Applicatins can be delivered t the Custmer Service Centre in Garden Place r psted t Hamiltn City Cuncil, Private Bag 3010, Hamiltn Yu can als apply nline n ur website: FEE DUE: $ Office Use Only: Accepted by: Receipt number: Receipt date: T T Frm DLC019 March 2017

2 Applicatin fr Renewal f Manager s Certificate Sectin 224, Sale and Supply f Alchl Act 2012 T the Secretary District Licensing Cmmittee, Hamiltn City Cuncil Applicatin fr the renewal f a manager s certificate is made in accrdance with the details set ut belw. Applicant details 1. Title Mr Dr 2. Surname: Mrs Prf Ms Sir Miss 3. First name(s): 4. Middle name(s): 5. Any aliases: 6. Sex: 7. Date f birth: 8. Place f birth: 9. Driver s licence r passprt number: 10. Residential address: 11. Pstal address (fr service f dcuments): Pstcde: Frm DLC019 March 2017

3 12. Hme phne: Wrk phne: Mbile phne: 13. address: 14. Daytime cntact details (if different frm abve) Name: Phne number: Mbile number: address: Applicatin details 15. Are yu a New Zealand citizen r permanent resident? Yes N If n, please attach cpy f yur passprt and visa. 16. D yu have any criminal cnvictins? (ther than cnvictins fr ffences against prvisins f the Land Transprt Act 1998 nt cntained in Part 6, and ffences t which the Criminal Recrds (Clean Slate) Act 2004 applies) Yes N If YES, please state the nature f the ffence, date f cnvictin and penalty suffered: Nature f the ffence Date f cnvictin Penalty suffered Frm DLC019 March 2017

4 17. Name and address f licensed premises at which yu are currently emplyed. 18. Yur ccupatin / duties at this licensed premises: 19. Hw lng have yu been emplyed at this licensed premises? 20. Hw many hurs per week (n average) d yu wrk at this licensed premises? 21. Is this yur main emplyment? Yes N If NO, what is yur main emplyment? 22. What steps have yu taken t manage the sale and supply f alchl pursuant t the licence with the aim f cntributing t the reductin f alchl-related harm? 23. D yu hld the Licence Cntrller Qualificatin (LCQ)? Yes N If YES, n what date was that qualificatin btained? Frm DLC019 March 2017

5 Manager s certificate details 24. Manager s certificate number: 25. Expiry date: Declaratin The New Zealand plice are required by the Sale and Supply f Alchl Act 2012 t make inquiries int the suitability f the applicant. This will invlve infrming the District Licensing Cmmittee and the Alchl Regulatry and Licensing Authrity f any cnvictins r cncerns invlving the applicant. Shuld there be any cncerns, the applicant will als be infrmed. I cnsent t the release f this infrmatin I hereby state that the abve particulars are true and crrect I understand that my applicatin will nt be ldged with Cuncil until the applicatin fee is paid and all required dcuments are supplied. Incmplete applicatins will be returned. [Applicant name] [Signature] [Date] Cntact us: Phne: (07) licensing@hcc.gvt.nz Website: Lcatin: Service Centre - Grund Flr, Garden Place, Hamiltn Frm DLC019 March 2017

6 Manager s Certificate infrmatin What is a manager s certificate? A manager s certificate allws the hlder t be appinted as a duty manager f licensed premises fr the purpses f the Sale and Supply f Alchl Act A certificated manager must be n duty at all times when alchl is being sld r supplied t the public n any licensed premises. The bligatins f a duty manager The duty manager is respnsible fr the cmpliance with and enfrcement f the prvisins f the act and the cnditins f the licence in frce n the premises. While n duty, the name f the manager must be prminently displayed. Making an applicatin fr manager s certificate Applicants must be 20 years f age r ver. Cmplete an applicatin frm and ensure all required dcumentatin is attached as utlined in the applicatin checklist. Incmplete applicatins will be returned. Criteria Yur suitability t hld a manager s certificate will be assessed in accrdance with the fllwing criteria: Character and reputatin Any previus cnvictins recrded Experience wrking n licensed premises - a reasnable amunt f recent experience is required, usually at least six mnths Relevant training and qualificatins applicants are required t have the Licence Cntrller Qualificatin (LCQ) Yu must be currently wrking in the alchl industry Licence Cntrller Qualificatin (LCQ) All applicants must btain the LCQ befre yu can hld a manager's certificate. The qualificatin cnsists f tw NZQA unit standards: 4646: Demnstrate knwledge f the Sale and Supply f Alchl Act 2012 and its implicatins fr licensed premises 16705: Demnstrate knwledge f hst respnsibility requirements as a duty manager f licensed premises Fr further infrmatin, see the Service IQ website: LCQ Bridging Test The LCQ Bridging Test was an nline test fr peple wh cmpleted their LCQ training under the repealed Sale f Liqur Act It was available frm 18 December 2013 until 31 January If yu btained yur LCQ befre December 2013 under the Sale f Liqur Act 1989 and did nt cmplete the bridging test within the abve dates, yu will need t cmplete the LCQ curse again under the new Act. If yu have already cmpleted the LCQ Bridging Test, yu can btain a cpy f yur cmpletin certificate at The applicatin prcess Applicatins can take apprximately 4-6 weeks t prcess, r lnger if there is any ppsitin. A cpy f the applicatin is sent t the Plice and the Licensing Inspectr wh will reprt n the applicatin. Yu will be required t attend an interview with the Licensing Inspectr, which will include a test n the Sale and Supply f Alchl Act Yu will be cntacted after yur applicatin has been received t arrange an appintment. Please allw up t three weeks fr us t cntact yu fr an interview. Finally, nce all dcumentatin and reprts are received, the applicatin is then put befre the District Licensing Cmmittee (DLC) fr their decisin. If yur applicatin is ppsed, a hearing may be required. Yu will receive ntificatin f the DLC's decisin via mail. Renewal applicatins All manager's certificates expire after an initial 12 mnth perid, unless yu apply t renew it. It is respnsibility f the manager's certificate hlder t ensure the applicatin fr renewal is made befre it expires. An expired certificate cannt be renewed. If yur certificate expires, yu will need t make an applicatin fr a new manager s certificate again. Once yur certificate is renewed, it will be valid fr anther three years befre it needs t be renewed again. Suspensin/cancellatin f manager s certificate The plice r licensing inspectr can apply t the Alchl Regulatry and Licensing Authrity (ARLA) t suspend r cancel a manager s certificate if they believe that the manager failed t cnduct licensed premises in a prper manner r the cnduct f the manager indicates that he r she is nt a suitable persn t hld a manager s certificate. Temprary manager A temprary manager can be appinted if a manager is ill r absent fr any reasn, r resigns. The licensee may appint a persn wh is nt the hlder f a manager s certificate as a temprary manager. A Ntice f Management Change must be cmpleted by the licensee and sent t the DLC and plice. If the DLC des nt apprve f the appintment, they have five wrking days t advise f this. The persn appinted as a temprary manager must apply fr a manager s certificate within tw wrking days. He r she may then cntinue as a temprary manager until the applicatin fr a manager s certificate is determined. Acting manager An acting manager can be appinted when a manager is ill r absent fr a maximum f three weeks. It is nt necessary fr this persn t apply fr a manager s certificate. Once again the Ntice f Management Change must be cmpleted by the licensee and sent t the DLC and Plice. Frm DLC019 March 2017

Application Checklist: Supporting documents you need to provide with your application: o Application fee

Application Checklist: Supporting documents you need to provide with your application: o Application fee Applicatin fr Special Licence Sectin 138, Sale and Supply f Alchl Act 2012 General infrmatin: Office Use Only An applicatin fr a special licence MUST be ldged at least 20 wrking days befre the event(s)

More information

Renewal of Off-Licence

Renewal of Off-Licence Applicatin fr Renewal f Off-Licence Sectin 127, Sale and Supply f Alchl Act 2012 General infrmatin: An applicatin fr renewal f club licence must be filed at least 20 wrking days befre the licence is due

More information

Tenancy Application Form

Tenancy Application Form Tenancy Applicatin Frm Applicatins will nly be prcessed nce this applicatin is fully cmpleted. Shuld the applicant fail t prvide the fllwing details the applicatin will nt be prcessed. If yur applicatin

More information

Privacy & Data Protection Policy

Privacy & Data Protection Policy Privacy & Data Prtectin Plicy Whitby & District Fishing Industry Training Schl Limited and 54 Nrth Maritime Training ("Whitby Fishing Schl", WDFITS, 54 Nrth Maritime "we" r "us") are cmmitted t prmting

More information

APPLICATION FORM LICENSED TRADES ISSUE OF QUALIFICATION POST GAP TRAINING. SECTION A Applicant Details & Document Checklist

APPLICATION FORM LICENSED TRADES ISSUE OF QUALIFICATION POST GAP TRAINING. SECTION A Applicant Details & Document Checklist APPLICATION FORM LICENSED TRADES ISSUE OF QUALIFICATION POST GAP TRAINING SECTION A Applicant Details & Dcument Checklist INSTRUCTIONS FOR APPLICANTS This Applicatin Frm is a request fr the issue f a qualificatin,

More information

BECCLES INDOOR BOWLS CLUB

BECCLES INDOOR BOWLS CLUB . BECCLES INDOOR BOWLS CLUB PRIVACY NOTICE FOR OUR MEMBERS We are cmmitted t respecting yur privacy. This ntice is t explain hw we may use persnal infrmatin we cllect befre, during and after yur membership

More information

AUSTRALIAN CAPITAL TERRITORY (ACT) REGIONAL CERTIFYING BODY (RCB)

AUSTRALIAN CAPITAL TERRITORY (ACT) REGIONAL CERTIFYING BODY (RCB) AUSTRALIAN CAPITAL TERRITORY (ACT) REGIONAL CERTIFYING BODY (RCB) APPLYING FOR RCB SUPPORT OF AN EMPLOYER NOMINATION REGIONAL SPONSORED MIGRATION SCHEME (RSMS) Skills Canberra September 2017 1 P a g e

More information

C>bmeA 9D3-C{r;{ J-I 00;:)"

C>bmeA 9D3-C{r;{ J-I 00;:) Cmmercial Driver Applicatin fr Emplyment Cmpany Name: -Ll,),R Q.[)S PQf't \L\ \ \J --=s uds"')'i'"3=d, State, Zip: \~\'f-.. '---IS C>bmeA 9D3-C{r;{ J-I 00;:)" Q03-Qe,)- 0\0

More information

Caregiver/Respite Application (Please print)

Caregiver/Respite Application (Please print) 52 Armstrng Rad Plymuth, MA 02360 WWW.THEARCOFGP.ORG Email:Inf@Thearcfgp.rg PHONE: 508.732.9292 FAX: 508.732.9229 Caregiver/Respite Applicatin (Please print) Name Last First Middle Address Street City

More information

Employee Hardship Assistance Policy

Employee Hardship Assistance Policy Emplyee Hardship Assistance Plicy Functinal Area: Human Resurces Applies T: All Faculty and Staff Plicy Reference(s): N/A Number: TBD Date Issued: March 4, 2013 Page(s): 6 Respnsible Persn The Directr

More information

Application for Employment (Please print)

Application for Employment (Please print) Crdage Cmmerce Center 10 Crdage Park Circle Suite 208 Plymuth, MA 02360 WWW.THEARCOFGP.ORG Email:Inf@Thearcfgp.rg PHONE: 508.732.9292 FAX: 508.732.9229 Applicatin fr Emplyment (Please print) Name Last

More information

ILLINOIS INSTITUTE OF TECHNOLOGY J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE SCHOLAR)

ILLINOIS INSTITUTE OF TECHNOLOGY J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE SCHOLAR) J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE SCHOLAR) Please cmplete this frm and return it t yur hst department as sn as pssible s that we may issue yu a DS-2019, which is used when yu apply fr a

More information

HEAVY DUTY EQUIPMENT TECHNICIAN

HEAVY DUTY EQUIPMENT TECHNICIAN T qualify t challenge certificatin in this trade r be granted authrity t supervise and sign-ff n apprentices in this trade, individuals must have: wrked a minimum f 9,540 hurs perfrming the tasks listed

More information

REFERENCE NUMBER: PFS.PDS.115. TITLE: Patient Billing and Collections CURRENT EFFECTIVE DATE: 01/01/2018. PAGE 1 of 8 SCOPE:

REFERENCE NUMBER: PFS.PDS.115. TITLE: Patient Billing and Collections CURRENT EFFECTIVE DATE: 01/01/2018. PAGE 1 of 8 SCOPE: PAGE 1 f 8 SCOPE: This Patient Billing and Cllectins Plicy applies t all Presbyterian Healthcare Services (Presbyterian) hspital facilities, including inpatient, utpatient, hme health care services and

More information

EMPLOYMENT APPLICATION LEE COUNTY GOVERNMENT P.O. Box 398 ATT: Human Resources Fort Myers, Florida (239)

EMPLOYMENT APPLICATION LEE COUNTY GOVERNMENT P.O. Box 398 ATT: Human Resources Fort Myers, Florida (239) PERSONAL INFORMATION EMPLOYMENT APPLICATION LEE COUNTY GOVERNMENT P.O. Bx 398 ATT: Human Resurces Frt Myers, Flrida 33902 (239) 533-2245 http://www.lee-cunty.cm JOB NUMBER: JOB TITLE: EXAM ID#: Received:

More information

PLAN DOCUMENT TEMPORARY DISABILITY INSURANCE PROGRAM FOR LAY EMPLOYEES DIOCESE OF METUCHEN OFFICE OF HUMAN RESOURCES. Effective January 1, 2014

PLAN DOCUMENT TEMPORARY DISABILITY INSURANCE PROGRAM FOR LAY EMPLOYEES DIOCESE OF METUCHEN OFFICE OF HUMAN RESOURCES. Effective January 1, 2014 DIOCESE OF METUCHEN OFFICE OF HUMAN RESOURCES TEMPORARY DISABILITY INSURANCE PROGRAM FOR LAY EMPLOYEES PLAN DOCUMENT Effective January 1, 2014 (Replaces January 1, 2013 Plan Dcument) 1 CONTENTS OVERVIEW...

More information

Subject Access Requests

Subject Access Requests Subject Access Requests The Data Prtectin Act 1998 gives rights t individuals in respect f the persnal data that rganisatins hld abut them. One f thse rights is the right t get a cpy f the infrmatin that

More information

SPECIAL CIRCUMSTANCES REPAYMENT / REMISSION / RE-CREDIT APPLICATION

SPECIAL CIRCUMSTANCES REPAYMENT / REMISSION / RE-CREDIT APPLICATION INSTRUCTIONS SPECIAL CIRCUMSTANCES REPAYMENT / REMISSION / RE-CREDIT APPLICATION Wh shuld use this frm? This frm applies t all internatinal and dmestic fee paying students and all dmestic Cmmnwealth supprted

More information

Employment Application. Name: Last First Middle. Home ( ) Alternate( ) Type: i.e. cell phone, message, etc. Social Security No.

Employment Application. Name: Last First Middle. Home ( ) Alternate( ) Type: i.e. cell phone, message, etc. Social Security No. Tribal Lending Enterprise (TLE) a whlly wned Crpratin f the Habematlel Pm f Upper Lake 635 B E. Hwy 20 Upper Lake, CA 95485-0516 7300 Cllege Blvd., Ste. 650, Overland Park, KS 66210 D: (913) 717-4664 TF:

More information

Western Management 1654 The Alameda Suite 100 San Jose, California

Western Management 1654 The Alameda Suite 100 San Jose, California Fax COMMUNITY NAME PROPERTY MANAGER FROM FAX PAGES PHONE DATE REGARDING Rental Applicatin CC Urgent Fr Review Please Cmment Please Reply Please Recycle Cmments: Western Management 1654 The Alameda Suite

More information

Direct Entry Pre-Approval Requirements for Level II Technician Candidates

Direct Entry Pre-Approval Requirements for Level II Technician Candidates Direct Entry Pre-Apprval Requirements fr Level II Technician Candidates The Direct Entry prgram is intended t allw rpe access technicians wh have btained rpe access skills and experience n an industrial

More information

IDENTIFICATION FORM AUSTRALIAN COMPANY

IDENTIFICATION FORM AUSTRALIAN COMPANY AUSTRALIAN COMPANY GUIDE TO COMPLETING THIS FORM This frm is fr nly. Fr cmpanies incrprated r registered utside f Australia use the FOREIGN COMPANY IDENTIFICATION FORM. Cmplete ne frm fr each cmpany. Tax

More information

MICRO GROUP EMPLOYER DOCUMENTATION REQUIREMENTS

MICRO GROUP EMPLOYER DOCUMENTATION REQUIREMENTS Seattle, Washingtn 98101 MICRO GROUP EMPLOYER DOCUMENTATION REQUIREMENTS D nt cancel any existing plicies until yu receive cnfirmatin f final rates and/r acceptance f the grup by Regence BlueShield (Regence).

More information

Producer Statements will be accepted only in accordance with this policy.

Producer Statements will be accepted only in accordance with this policy. Prducer Statements Plicy This plicy has been prepared t ensure that Cuncil has clearly dcumented plicies and prcedures fr the request fr and acceptance f Prducer Statements in cnnectin with applicatins

More information

Appeal Process Overview

Appeal Process Overview Appeal Prcess Overview www.ptbard.bc.ca Scpe f Appeals The Bard may hear appeals frm administrative penalties impsed n a licensee by the Registrar f Passenger Transprtatin Parties t Appeals The appellant

More information

APPLICATION FOR ADMISSION 2019

APPLICATION FOR ADMISSION 2019 APPLICATION FOR ADMISSION 2019 APPLICANT INFORMATION Last Name: First Name: Date f Birth: (mnth/day/year) Gender: Male Female Citizenship: Hme Cuntry Address: City: State/Prvince: Pstal Cde: Cuntry: E-mail:

More information

Customer due diligence guide for clients

Customer due diligence guide for clients Custmer due diligence guide fr clients Nvember 2018 19499409 2 As a reprting entity under the Anti-Mney Laundering and Cuntering Financing f Terrrism Act 2009 (the AML/CFT Act), MinterEllisnRuddWatts has

More information

Sewer Blockage Procedure

Sewer Blockage Procedure Sewer Blckage Prcedure I N F O R M A T I O N F O R P L U M B E R S J U N E 2 0 1 7 When a blckage is identified in the sewer Huse Cnnectin Branch (HCB) we will review the issue and in sme circumstances:

More information

INTERNATIONAL COLLEGE OF MANAGEMENT, SYDNEY

INTERNATIONAL COLLEGE OF MANAGEMENT, SYDNEY INTERNATIONAL COLLEGE OF MANAGEMENT, SYDNEY PROFESSIONAL SCHOLARSHIP PROGRAM APPLICATION Frntrw Grup Schlarship Applicatin Frm September 2017 Phne: 1800 110 490 email: icmsschlarships@icms.edu.au www.icms.edu.au

More information

Verifying Your Account & Identity

Verifying Your Account & Identity Verifying Yur Accunt & Identity Acceptable Identificatin Dcumentatin The Anti Mney Laundering and Cunter Terrrism Financing Act 2006, requires Luxbet t verify the identity f anyne wh pens a new wagering

More information

OAKVIEW CONDOMINIUM ASSOC INC.

OAKVIEW CONDOMINIUM ASSOC INC. Versin UPD: 10/2/17 OAKVIEW CONDOMINIUM ASSOC INC. APPLICATION FOR LEASE/ PURCHASE INSTRUCTIONS Nn Refundable Applicatin Fee f $100.00 Husband & Wife r Parent/Dependent Child. Any applicant applying as

More information

You can get help from government organizations that are not connected with us

You can get help from government organizations that are not connected with us 2011 Evidence f Cverage fr Medi-Pak Advantage MA (PFFS) Chapter 9: What t d if yu have a prblem r cmplaint (cverage decisins, appeals, cmplaints) BACKGROUND SECTION 1 Intrductin Sectin 1.1 What t d if

More information

FOR PLAN ADMINISTRATORS

FOR PLAN ADMINISTRATORS QDRO INFORMATIONAL KIT FOR PLAN ADMINISTRATORS T ensure cmpliance with requirements impsed by the IRS, we infrm yu that any infrmatin cntained in this cmmunicatin (including any attachments) was nt intended

More information

Guide to Young Adult Dependent Coverage

Guide to Young Adult Dependent Coverage Guide t Yung Adult Dependent Cverage The New Yrk State Legislature passed a law in 2009 which extends the availability f health insurance cverage t yung adults thrugh the age f 29. As a result, Freelancers

More information

Instruction Page. Verification of 2014 Income Information for Individuals with Unusual Circumstances

Instruction Page. Verification of 2014 Income Information for Individuals with Unusual Circumstances Instructin Page Imprtant Nte: Please ntify the financial aid ffice if the student r their parents had a change in marital status after the end f the 2014 tax year n December 31, 2014 and als if the parents

More information

Alternative Exam Arrangements

Alternative Exam Arrangements A Series f Fact Sheets fr Students Alternative Exam Arrangements Sme students with disability/health cnditins may require alternative arrangements t successfully cmplete their examinatins. Temprary Disability

More information

Privacy Notice for Applicants and Tenants

Privacy Notice for Applicants and Tenants Privacy Ntice fr Applicants and Tenants What we need Scttish Brders Husing Assciatin (SBHA) will be a "cntrller" f the persnal infrmatin that yu prvide t us thrugh yur cmpleted Husing Applicatin Frm, and

More information

VOLUNTEER REGISTRATION FORM

VOLUNTEER REGISTRATION FORM VOLUNTEER REGISTRATION FORM Office Use Only Prgram: Site: Day(s): Time: Name Email: Phne Number (cell) (hme) (Wrk) Address Birth date What is yur current ccupatin? Are yu r have yu ever been a member f

More information

Philippines Mission Experience 2018

Philippines Mission Experience 2018 Glwa Campus: (08) 8555 7500 Victr Harbr Campus: (08) 8551 0900 Investigatr Cllege Philippines Missin Experience 2018 Update - Nvember 2017 Dear Parents/Caregivers and students Thank yu fr yur interest

More information

Western Management PO Box San Jose, California

Western Management PO Box San Jose, California Fax COMMUNITY NAME PROPERTY MANAGER FROM FAX PAGES PHONE DATE REGARDING Rental Applicatin CC Urgent Fr Review Please Cmment Please Reply Please Recycle Cmments: Western Management PO Bx 26824 San Jse,

More information

ILL HEALTH INCAPACITY: MANAGEMENT GUIDELINES

ILL HEALTH INCAPACITY: MANAGEMENT GUIDELINES ILL HEALTH INCAPACITY: MANAGEMENT GUIDELINES PURPOSE The purpse f this dcument is t prvide guidelines t line managers regarding incapacity due t ill health, and t ensure alignment with prcedures and prcesses

More information

The UK Register of Trusts 23 October 2017

The UK Register of Trusts 23 October 2017 The UK Register f Trusts 23 Octber 2017 If yu are a trustee f a UK resident trust r f a nn-resident trust which has UK assets r UK surce incme yu may need t take actin befre 5 December 2017. Backgrund

More information

Explanation of a U.S. Address and/or U.S. Phone Number (S3)

Explanation of a U.S. Address and/or U.S. Phone Number (S3) Explanatin f a U.S. Address and/r U.S. Phne Number (S3) Custmer Name Custmer Number By cmpleting yur IRS Frm W-8 yu are affirming that yu are nt a citizen r resident f the United States r ther U.S. persn

More information

OSHA INSPECTION CHECKLIST

OSHA INSPECTION CHECKLIST OSHA INSPECTION CHECKLIST HANDLING AN OSHA INSPECTION The Occupatinal Safety and Health Act (OSH Act) authrizes the Occupatinal Safety and Health Administratin (OSHA) t cnduct wrkplace inspectins and investigatins

More information

Application for Rent-Geared-to-Income Assistance Form 1 (Part 1)

Application for Rent-Geared-to-Income Assistance Form 1 (Part 1) Applicatin fr Rent-Geared-t-Incme Assistance: Applicatin fr Rent-Geared-t-Incme Assistance Frm 1 (Part 1) Instructins 1. Please print, and fill ut all sectins f the applicatin frm. Yu will find infrmatin

More information

Information Checklist for Candidates

Information Checklist for Candidates INSTRUCTIONS: All candidates must bring dcuments as stated in pints 1, 2, 3, 4 and 5. Bx 6 states additinal requirements fr nn EEA students. Originals AND phtcpies are required where stated. Instructins

More information

Change of circumstances

Change of circumstances Change f circumstances Participants f the Natinal Disability Insurance Scheme and peple wh are waiting n the utcmes f their access requests must by law tell the NDIA f any changes in their circumstances.

More information

We process personal data for some or all of the following purposes depending on our relationship with the individual data subject:

We process personal data for some or all of the following purposes depending on our relationship with the individual data subject: PRIVACY POLICY Our purpses fr prcessing yur persnal data We prcess persnal data fr sme r all f the fllwing purpses depending n ur relatinship with the individual data subject: T adhere with all statutry

More information

De minimis aid declaration

De minimis aid declaration De minimis aid declaratin Declaratin within the scpe f the prvisin f aid as referred t in the de minimis aid Regulatin (OJ 2006, L379). It is recmmended that yu read the explanatry ntes in the annex t

More information

CRG PATIENT REGISTRATION FORM

CRG PATIENT REGISTRATION FORM CRG PATIENT REGISTRATION FORM PATIENT INFORMATION Patient s Name: Birth : (Last) (First) (Middle) Scial Security Number: Male: Female: Hme Address: (Street / RR Bx # / Apt. #) (City/State) (Zip) Preferred

More information

How to reclassify your residency: for US citizens and permanent residents

How to reclassify your residency: for US citizens and permanent residents Hw t reclassify yur residency: fr US citizens and permanent residents When yu first attend UF grad schl, the university waives yur tuitin at the in- state rate fr a year as a grace perid during which yu

More information

Rural Tourism Infrastructure Fund. Initial Expression of Interest Form

Rural Tourism Infrastructure Fund. Initial Expression of Interest Form Rural Turism Infrastructure Fund Initial Expressin f Interest Frm 1 Befre yu cmplete this frm please ensure yu: IMPORTANT APPLICATION INFORMATION Read the Rural Turism Infrastructure Fund Criteria, Cnditins

More information

APPLICATION OF EMPLOYMENT FOR PRINCIPAL ASSISTANT PRINCIPAL TEACHER

APPLICATION OF EMPLOYMENT FOR PRINCIPAL ASSISTANT PRINCIPAL TEACHER APPLICATION OF EMPLOYMENT FOR PRINCIPAL ASSISTANT PRINCIPAL TEACHER Applicatins are accepted nly fr pen psitins ****Please cmplete, print, sign and mail r e-mail t the schl where yu are applying. 1 Thank

More information

Application Instructions Effective February 8, 2013

Application Instructions Effective February 8, 2013 Applicatin Instructins Effective February 8, 2013 D Step 1. Dwnlad and review the Admissins & Occupancy Plicy fr the prperty yu are interested in. Step 2. Dwnlad and print a cpy f the Applicatin Packet

More information

Personal accident claim form

Personal accident claim form Persnal accident claim frm Guidance ntes: Please arrange t return the fully cmpleted frm either by: Pst: Ftball PA Claims Team, Wdgate & Clark Ltd, The Red Huse, King Street, West Malling, Kent ME19 6QT

More information

VODACOM BROADBAND FIBRE

VODACOM BROADBAND FIBRE VODACOM BROADBAND FIBRE SECTION A: Custmer Details & Package Selectin Surname First Names ID Number Street Address Estate Suburb City Prvince Phne Number (Hme) Phne Number (Wrk) Phne Number (Cell) Email

More information

This Agreement is hereby confirmed to vary Terms & Conditions of employment between The Company and you.

This Agreement is hereby confirmed to vary Terms & Conditions of employment between The Company and you. Salary Sacrifice Agreement Terms & Cnditins This Agreement regulates yur participatin in the Simplydriveit prgramme, which has been implemented by Pendragn Cntracts Ltd fr (cmpany name here) Under the

More information

Please work with your department administrative assistant to submit the necessary paperwork, as they should be very familiar with this process

Please work with your department administrative assistant to submit the necessary paperwork, as they should be very familiar with this process Dear Faculty Member, Thank yu fr cntacting the Office f Internatinal and Cultural Affairs (OICA) cncerning yur intent t invite a visiting schlar t ur campus. Please wrk with yur department administrative

More information

A P P L I C A T I O N

A P P L I C A T I O N Fördernummer: Eingangsdatum: Aktenzeichen: Please send t: Universität Ulm Dezernat I Abteilung I-1, Frschung und Technlgietransfer Frau Sauter / Herr Dr Müller Helmhltzstraße 16 89081 Ulm A P P L I C A

More information

CONSENT FOR TREATMENT

CONSENT FOR TREATMENT Thank yu fr chsing 2 nd Street Dental, LLC as yur dental prvider. We are cmmitted t yur treatment being successful. Please understand that payment f yur fees is cnsidered part f yur treatments. The fllwing

More information

All applicants and listed vendors must submit a criminal background check valid

All applicants and listed vendors must submit a criminal background check valid AMENDMENT TO APPLICATION Receipt # Receipt # Date Submitted Date Submitted Amunt paid Amunt paid COMMERCIAL VENDOR APPLICATION PEDDLING, SOLICITING, SPECIAL EVENT VENDOR, VENDOR AT ATHLETIC EVENT Chapter

More information

GUARANTEE AGREEMENT. This guarantee is made between: (1) [ Full Name & Address ] (the Guarantor )

GUARANTEE AGREEMENT. This guarantee is made between: (1) [ Full Name & Address ] (the Guarantor ) GUARANTEE AGREEMENT This guarantee is made between: (1) [ Full Name & Address ] (the Guarantr ) 2) Derwent Facilities Management Limited (cmpany number 07264667) (Trading as Derwent Students) f N.1 Centr

More information

ApplicantCare is an online application and candidate management tool that automates the hiring process.

ApplicantCare is an online application and candidate management tool that automates the hiring process. Plicy Overview It is the plicy f Kelis t prvide equal emplyment pprtunities. Emplyment decisins and actins will be cnducted withut regard t gender, sexual rientatin, race, clr, age, natinal rigin, ancestry,

More information

Handling Complaints at Lloyd s: Guidance for managing agents and their representatives

Handling Complaints at Lloyd s: Guidance for managing agents and their representatives Cmplaints May 2017 Llyd s cmplaints Handling Cmplaints at Llyd s: Guidance fr managing agents and their representatives This guidance nte prvides a practical prcess fr handling UK cmplaints received frm

More information

(FAMILY NAME) Qualified Small Employer Health Reimbursement Arrangement

(FAMILY NAME) Qualified Small Employer Health Reimbursement Arrangement (FAMILY NAME) Qualified Small Emplyer Health Reimbursement Arrangement Effective Date: Emplyer / Plan Administratr Emplyer Name: Address: Phne Number: ( ) - Federal Emplyer Identificatin Number: The emplyer

More information

APPLICATION FORM FOR ASSISTANCE FROM THE AFRICAN WORLD HERITAGE FUND

APPLICATION FORM FOR ASSISTANCE FROM THE AFRICAN WORLD HERITAGE FUND APPLICATION FORM FOR ASSISTANCE FROM THE AFRICAN WORLD HERITAGE FUND This template is the riginal assistance request frm which when sent shuld cver all the questins asked. It can be adjusted t accmmdate

More information

The Company is a public company incorporated in Bermuda and its securities are listed on AIM.

The Company is a public company incorporated in Bermuda and its securities are listed on AIM. (Incrprated in Bermuda Registratin N. 44512) POLICY FOR TRADING IN COMPANY SECURITIES The Cmpany is a public cmpany incrprated in Bermuda and its securities are listed n AIM. Schedule 1 t this Plicy cntains

More information

Please Note: It is your sole responsibility to review and understand your employer's policies

Please Note: It is your sole responsibility to review and understand your employer's policies MICROSOFT RETAIL EXPERTZONE PROMOTION OFFICIAL RULES Please Nte: It is yur sle respnsibility t review and understand yur emplyer's plicies regarding yur eligibility t participate in trade prmtins such

More information

APPLICATION FOR RESIDENTIAL TENANCY

APPLICATION FOR RESIDENTIAL TENANCY Head ffice: 7/29 Cllier Rad, Mrley WA 6062 (08) 9207 2088 Wangara ffice: 1/7 Prindiville Dr, Wangara WA 6065 (08) 9409 7577 admin@xceedre.cm.au 1. PROPERTY DETAILS APPLICATION FOR RESIDENTIAL TENANCY PROPERTY

More information

Europa Group Privacy Policy

Europa Group Privacy Policy Eurpa Grup Privacy Plicy The privacy and security f yur persnal infrmatin is very imprtant t us (Eurpa Grup). This plicy explains hw we cllect and use yur persnal infrmatin. Please read it carefully. This

More information

Form 1B AU UK Competent Authority (CA)

Form 1B AU UK Competent Authority (CA) Frm 1B AU UK Cmpetent Authrity (CA) Applicatin fr Assessment fr Registratin in Australia via the Cmpetent Authrity Pathway This frm is fr the use f Ostepaths wh are bth: 1. Graduates frm ne f the listed

More information

Financial Assistance Conference/Travel Bursary Application Form

Financial Assistance Conference/Travel Bursary Application Form Financial Assistance Cnference/Travel Bursary Applicatin Frm At the discretin f the Bard: 1. Membership f a Lcal Assciatin must be current and cntinuus fr at least tw years. 2. The Lcal Assciatin President

More information

Independent Director and Audit Committee

Independent Director and Audit Committee Independent Directr and Audit Cmmittee Rules summary The listed cmpany s bard f directrs is representing the sharehlders. They are respnsible fr making decisins n the cmpany s imprtant plicies and strategies.

More information

Financial Aid Satisfactory Academic Progress Appeal Request Spring 2019 Deadline: January 3, 2019

Financial Aid Satisfactory Academic Progress Appeal Request Spring 2019 Deadline: January 3, 2019 Financial Aid 2018-2019 Satisfactry Academic Prgress Appeal Request Spring 2019 Deadline: January 3, 2019 Is this yur first appeal? (Currently n Financial Aid Suspensin) Is this yur secnd appeal? (Appeal

More information

ILLINOIS INSTITUTE OF TECHNOLOGY J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE DEPARTMENT)

ILLINOIS INSTITUTE OF TECHNOLOGY J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE DEPARTMENT) J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE DEPARTMENT) Please cmplete this frm and return it, alng with the individual s sectin, t the Internatinal Center as sn as pssible s that we may issue the

More information

OFFICE OF THE PRESIDENT HUMAN RESOURCES POLICY MANUAL SECTION 11 JULY 28, 2006 REDUCTION IN FORCE GUIDELINES

OFFICE OF THE PRESIDENT HUMAN RESOURCES POLICY MANUAL SECTION 11 JULY 28, 2006 REDUCTION IN FORCE GUIDELINES Purpse A reductin in frce is an actin t reduce the number f emplyees in a wrk unit r university-wide. A reductin in frce may becme necessary due t reduced funding, rerganizatin, change in wrklad, r ablishment

More information

Karuk Tribe Housing Authority Application & Checklist

Karuk Tribe Housing Authority Application & Checklist Karuk Tribe Husing Authrity Applicatin & Checklist Please make sure that all infrmatin in this applicatin is accurate. The applicatin must be cmpleted in full and all the attachments must be submitted

More information

Quality of Life Equipment Grants

Quality of Life Equipment Grants Quality f Life Equipment Grants Abut the Quality f Life Equipment Grants Prgram The MS Sciety f Canada makes available t individuals living with multiple sclersis (MS) a Quality f Life Equipment Grants

More information

JOHN L. LITTLE, D.D.S, P.A ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES. May Refuse to Sign This Acknowledgement-

JOHN L. LITTLE, D.D.S, P.A ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES. May Refuse to Sign This Acknowledgement- JOHN L. LITTLE, D.D.S, P.A ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES -Yu I, Privacy Practices. May Refuse t Sign This Acknwledgement- ---, have received a cpy f this ffice's Ntice f {Please

More information

TERMS AND CONDITIONS FOR APPOINTMENT OF INDEPENDENT DIRECTOR

TERMS AND CONDITIONS FOR APPOINTMENT OF INDEPENDENT DIRECTOR TERMS AND CONDITIONS FOR APPOINTMENT OF INDEPENDENT DIRECTOR 1 PRIVATE & CONFIDENTIAL Date: T, Independent Directrs, Subject: Appintment as an Independent Directr InfBeans Technlgies Limited Dear Sir/Madam,

More information

Temporary Rental Unit - Zoning Clearance Application Packet

Temporary Rental Unit - Zoning Clearance Application Packet Temprary Rental Unit - Zning Clearance Applicatin Packet Cunty f Ventura Resurces Management Agency Planning Divisin 800 S. Victria Avenue, Ventura, CA 93009 (805)654-2488 www.vcrma.rg/divisins/planning

More information

ABORIGINAL ECONOMIC PARTNERSHIPS Program Application Guidelines

ABORIGINAL ECONOMIC PARTNERSHIPS Program Application Guidelines ABORIGINAL ECONOMIC PARTNERSHIPS Prgram Applicatin Guidelines The Abriginal Ecnmic Partnerships Prgram (AEPP) supprts Abriginal cmmunities, businesses and rganizatins t increase participatin in ecnmic

More information

Checking and Savings Account Application

Checking and Savings Account Application Checking and Savings Accunt Applicatin Please use the Checking and Savings Accunt Applicatin t: Open a FREE Checking r Dividend Checking and Opt-in r Out f DCU s Overdraft Payment Service including an

More information

NCTJ Conflicts of Interest Policy and Procedures

NCTJ Conflicts of Interest Policy and Procedures NCTJ Cnflicts f Interest Plicy and Prcedures Purpse This plicy aims t draw attentin t the pssibility f cnflicts, minimise r prevent a cnflict ccurring and manage cnflicts that have arisen. Definitin f

More information

Enforceable Undertakings Operational Policy

Enforceable Undertakings Operational Policy Enfrceable Undertakings Operatinal Plicy Enfrceable Undertakings Operatinal Plicy. Nvember 2018 Page 1 f 13 Enfrceable Undertakings Operatinal Plicy This plicy sets ut Maritime NZ s apprach t enfrceable

More information

Terms and Conditions 19 December 2018

Terms and Conditions 19 December 2018 Stck and Shares Lifetime ISA (Prperty Saver) Terms and Cnditins 19 December 2018 These Terms, tgether with the Applicatin Frm, frm a legal agreement between yu and us which sets ut hw the Lifetime ISA

More information

REPRESENTATIVE PAYEE PROGRAM T. O. D., Inc.

REPRESENTATIVE PAYEE PROGRAM T. O. D., Inc. P.O. Bx 99243 Referral Checklist Client Infrmatin: Please cmplete t the best f yur ability adding as many details as available. Budget: The budget shuld be filled ut as cmpletely as pssible. If yu are

More information

This Privacy Notice applies to La Prairie employees, applicants and, where applicable, to contractors who provide services to La Prairie.

This Privacy Notice applies to La Prairie employees, applicants and, where applicable, to contractors who provide services to La Prairie. EMPLOYEE PRIVACY NOTICE Last updated 24 May, 2018. What des this ntice cver? References in this Privacy Ntice t La Prairie, we r us shall mean the La Prairie grup cmpany t which yu are applying r by which

More information

Morgan State University Edward T. Conroy Memorial Scholarship Program Application

Morgan State University Edward T. Conroy Memorial Scholarship Program Application Mrgan State University 2018-2019 Edward T. Cnry Memrial Schlarship Prgram Applicatin Imprtant Ntice: Please make sure that yu meet the eligibility requirements belw befre yu cmplete and submit yur applicatin

More information

Grant Application Guidelines

Grant Application Guidelines Grant Applicatin Guidelines The prgram staff f the Cmmunity Fundatin f Greater New Britain lks frward t wrking with yu. This frm is fr rganizatins that have submitted a Letter f Intent t us and were invited

More information

PERKINS REALTY RENTAL PROCEDURES

PERKINS REALTY RENTAL PROCEDURES PERKINS REALTY RENTAL PROCEDURES PERKINS REALTY DOES BUSINESS IN ACCORDANCE WITH THE FAIR HOUSING ACT, AND DOES NOT DISCRIMINATE ON THE BASIS OF SEX, SEXUAL ORIENTATION, MARTIAL STATUS, RACE, CREED, RELIGION,

More information

St. Paul s Lutheran Grade School Tuition Agreement Form

St. Paul s Lutheran Grade School Tuition Agreement Form St. Paul s Lutheran Grade Schl Tuitin Agreement Frm Schl Year: 2017-2018 2017-18 tuitin schedule is listed n the bttm f this dcument. St. Paul s Lutheran Grade Schl strives t prvide an envirnment cnducive

More information

Application for Coverage Under the Pre-Existing Condition Insurance Plan administered by the Arkansas Comprehensive Health Insurance Pool (CHIP)

Application for Coverage Under the Pre-Existing Condition Insurance Plan administered by the Arkansas Comprehensive Health Insurance Pool (CHIP) P. O. Bx 1460 Little Rck, AR 72203 Applicatin fr Cverage Under the Pre-Existing Cnditin Insurance Plan administered by the Arkansas Cmprehensive Health Insurance Pl (CHIP) This Applicatin fr cverage thrugh

More information

NO LATE ENTRIES WILL BE ACCEPTED.

NO LATE ENTRIES WILL BE ACCEPTED. THE INSTITUTE OF ADMINISTRATION AND COMMERCE IAC SUMMATIVE ASSESSMENT INFORMATION T prve yur cmpetency and gain an IAC recgnized qualificatin is the final step in yur studies. T d this, yu need t successfully

More information

International Complaints Handling: New Procedures in Italy. To advise of new complaints handling arrangements for Italy

International Complaints Handling: New Procedures in Italy. To advise of new complaints handling arrangements for Italy market bulletin Ref: Y5041 Title Purpse Type Frm Internatinal Cmplaints Handling: New Prcedures in Italy T advise f new cmplaints handling arrangements fr Italy Event Paul Brady Head f Market Cnduct Date

More information

INTERNATIONAL COLLEGE OF MANAGEMENT, SYDNEY

INTERNATIONAL COLLEGE OF MANAGEMENT, SYDNEY INTERNATIONAL COLLEGE OF MANAGEMENT, SYDNEY PROFESSIONAL SCHOLARSHIP PROGRAM APPLICATION Suths Cares HOSTPLUS ICMS Indigenus Schlarship Applicatin Frm February 2019 1 The Internatinal Cllege f Management,

More information

Application Pack for Secondment Opportunity

Application Pack for Secondment Opportunity Applicatin Pack fr Secndment Opprtunity This pack is fr thse wishing t apply fr a secndment t the Fire Strategy and Refrm Unit within the Crime, Plicing and Fire Grup in the Hme Office. The Unit has a

More information

CAREVEST MORTGAGE INVESTMENT CORPORATION Directions for Completing Retraction Requests

CAREVEST MORTGAGE INVESTMENT CORPORATION Directions for Completing Retraction Requests This package is ONLY fr Class A sharehlders f. Cntents f this package (5 pages): - Instructins fr cmpleting yur retractin request - Retractin Request frm fr CareVest Mrtgage Investment Crpratin The February

More information

FNB Connect & Service Provider 100MB Free Data Campaign. Terms and Conditions

FNB Connect & Service Provider 100MB Free Data Campaign. Terms and Conditions FNB Cnnect & Service Prvider 100MB Free Data Campaign Terms and Cnditins Date these rules were first published: 1 July 2017 Read these campaign rules carefully. These campaign rules ( rules ) explain yur

More information

The UK Register of Trusts 21 December 2017

The UK Register of Trusts 21 December 2017 The UK Register f Trusts 21 December 2017 If yu are a trustee f a UK resident trust r f a nn-resident trust which has UK assets r UK surce incme yu may need t take actin befre 5 January 2018. Backgrund

More information