Application Instructions Effective February 8, 2013
|
|
- Wilfrid French
- 5 years ago
- Views:
Transcription
1 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 (this file). D Step 3. Dwnlad and print a cpy f the Tenant Incme Questinnaire fr every adult member f the husehld age 18 r lder during the first year f the Lease wh will ccupy the apartment. Applicatin (First 3 pages) Step 4. Write the Name f the Cmmunity yu are applying t n the first line. Dalehaven Estates Central Canal Hmes / MLK Hmes II Shannn Glenn Apartments D Step 5. Leave the next line blank (i.e. Apartment Number, Rent Amunt, Qualify At). This will be filled in by the manager during the apprval prcess. Please refer t the Admissin & Occupancy Plicy D Step 6. Fill in the name f the c-applicants (anyne ver the age f 18 during the first year f the Lease) D Step 7. Fill in the Remaining infrmatin COMPLETELY. Incmplete applicatins will hld up mve in dates and have t be resubmitted. Head f Husehld will be the same thrughut this applicatin. All ccupants must be listed in the husehld cmpsitin sectin, including c-applicants etc. Applicant Criminal & Credit Check Release and Authrizatin Frm (Next 1 page) Step 8. Each applicant age 18 and lder during the first year f the Lease must fill ut this Credit & Criminal Authrizatin. Fill ut frm COMPLETELY except the "Fr Office Use Only" sectin f the page. This will be filled in by the manager during the apprval prcess. Please refer t the Admissin & Occupancy Plicy Landlrd Reference Check (Last 2 pages) Step 9. Leave entire frm blank, the manager will fill in infrmatin fr each Landlrd listed n yur applicatin and/r credit check. Step 10. Only sign and date page 2, under "Applicant/Tenant Signature" after reading the RELEASE statement abve signature line. Page 1
2 Return Frms t the Cmmunity Step 11. Mail r Deliver all frms t the apprpriate cmmunity in which yu are applying fr. Include a mney rder r cashier's check fr each applicant ver the age f 18 during the first year f the Lease fr the applicatin fee. N cash r persnal checks will be accepted. Refer t the Admissin and Occupancy Plicy fr the amunt r cntact the manager. Dalehaven Estates 3700 Justus Curt Evansville, IN Ph: (812) Central Canal Hmes / MLK Hmes II 1426 W. 29th Street Suite 210-A Mailbx 11 Indianaplis, IN Ph: (317) Shannn Glenn Apartments 280 Shamrck Curt Evansville, IN Ph: (812) General Ntes Use the same pen thrughut the applicatin. If yu make any mistakes, draw a line thrugh yur mistake (d nt scribble it ut), place yur initials next t the mistake, and crrect the answer. D nt use white ut. This will vid yur applicatin, and it will have t be resubmitted. Once all the infrmatin has been filled ut, submit the riginals t the apprpriate persn at the management ffice. These items can be mailed t the ffice using the address n ur website. Dn't frget t include the Applicatin Fee fr every adult member f the husehld in accrdance with the prperty's Admissin & Occupancy Plicy. If yu have any questins, please d nt hesitate t call r the management staff. Once yu applicatin is received, management will begin prcessing it in accrdance with the prperty's Admissin and Occupancy Plicy. Any blank items r incrrectly filled ut infrmatin will delay the prcessing f applicatins. THANK YOU FOR CHOOSING OUR PROPERTY TO CALL HOME!! Page 2
3 RENTAL HOUSING APPLICATION NAME OF APPLICANT: NAME OF CO-APPLICANT: (if applicable additinal applicatin must be cmpleted) NEW APPLICATION HOUSEHOLD ADDITION TRANSFER (Please Print) Time: A) Name: Phne: ( ) B) Address: (Street) (City) (State) (ZIP) C) Marital Status: Divrced / Widwed / Married / Single (Never Married) / Separated D) Driver's License # and State: HOUSEHOLD COMPOSITION List all persns that will be ccupying the unit. Full Name Relatinship t Head f Husehld Birth Date Scial Security Number Emplyed Student Head f Husehld - - Y / N Y / N - - YIN Y/N RENTAL HISTORY -- Last Tw Years Use Additinal sheet if necessary D) Present Landlrd Name: Phne: ( ) Landlrd Address: City: St: ZIP: Dates f Occupancy: t Related? Y/N Hw? E) Previus Address: Previus Landlrd Name: Phne: ( ) Landlrd Address: City: St: ZIP: Dates f Occupancy: t Related? Y/N Hw? F) Previus Address: Previus Landlrd Name: Phne: ( ) IHCDA Cmpliance Frm #18 Revised 1/1/11
4 Landlrd Address: Dates f Occupancy: t City: St: ZIP: Related? Y/N Hw? GENERAL QUESTIONS 1) yes n Have yu r any husehld member ever been cnvicted f a felny? 2) yes n Have yu ever been evicted? Reasn: 3) yes n Have yu r any husehld member been arrested/cnvicted f a drug related crime? 4) yes n Des anyne nt listed in the husehld cmpsitin n page ne plan t live with yu in the next 12 mnths? If yes, explain 5) yes n Will the Husehld be receiving Sectin 8 husing assistance? (If yes list agency name, cntact persn and phne number.) 6) yes n Are there any absent husehld members wh under nrmal cnditins wuld live with yu? 7) yes n Des an adult f this husehld have primary physical custdy f every child listed n this applicatin? 8) yes n Des yur husehld have r anticipate having any pets ther than thse used as a service animal? 9) yes n Des anyne in yur husehld have special needs? If yes explain? Lans: Credit Cards: Other: CREDIT REFERENCES CHARACTER REFERENCES Name: Relatinship: Phne: Name: Relatinship: Phne: IHCDA Cmpliance Frm #18 Revised 1/1/11
5 EMERGENCY CONTACT NUMBER In case f emergency, ntify: Hme Phne: ( ) Wrk Phne: ( ) Applicant certifies the abve infrmatin is true and accurate and understands that false r inaccurate infrmatin shall be cause fr denial f this applicatin r terminatin f any subsequent rental agreements. I/We are the nly persn(s) wh will reside in the apartment if this applicatin is apprved. Apartment wner r agents may verify all infrmatin given directly r thrugh reprting agencies. Acceptance f the applicatin is nt binding n apartment wner r agent until apprved in writing. Yu have applied t live in an apartment that is gverned by the Lw Incme Husing Tax Credit Prgram. This Prgram requires us t certify all f yur incme asset and eligibility infrmatin as part f determining yur husehld's eligibility. Prgram requirements state we must verify each incme and asset surce as well as ther claims f eligibility. We must determine this prir t granting yur eligibility and, if such eligibility is granted, each subsequent year yu remain in the unit. The undersigned is the persn(s) named abve and hereby authrizes Apartment Credit Services t cnduct a search f my Criminal Recrd, Plice Recrd and Mtr Vehicle Recrd infrmatin fr the purpse f btaining husing. Additinally, I authrize all cmpanies and law enfrcement agencies t release such infrmatin, and release them frm any liability and respnsibility frm ding s. A faxed cpy f this authrizatin shall be as valid as the riginal. If applicant cancels after tw (2) days, all mneys depsited shall be frfeited t the apartment wner. If apprved all mneys depsited with this applicatin will be applied tward security depsit and/r prcessing fee at wner's discretin. If an applicatin is denied fr ANY reasn a 90-day wait perid is required befre reapplying t this prperty. Head Signature: C-head Signature: Agent's Signature:.0, We encurage and supprt the natin's affirmative husing prgram in which there are n barriers t btaining husing because f race, clr, religin, sex, natinal rigin, handicap r familial status. IHCDA Cmpliance Frm #18 Revised 1/1/11
6 APPLICANT CRIMINAL & CREDIT CHECK RELEASE AND AUTHORIZATION FORM hereby authrize Shannn Glenn Apartments r ther authrized representative f the apartment cmmunity bearing this release, r cpy theref, t btain any infrmatin pertaining t criminal curt recrds and credit infrmatin. I hereby direct yu t release such infrmatin t Shannn Glenn Apartments r ther authrized representative f the apartment cmmunity hereby fully release and discharge Shannn Glenn Apartments, their emplyees, agents, attrney, and their respective affiliates frm all claims and damages arising ut f r relating t any investigatins f my backgrund fr residency at Shannn Glenn Apartments. Name: First, Middle, Last Print Clearly Other Name / Alias / Maiden Name: Date f Birth: Scial Security N: Hw lng have yu been at yur current address? Current Address: Street City, State, Zip Cde Have yu ever been cnvicted fr any crime, including sex-related r child-abuse related ffenses? N Yes FOR OFFICE USE ONLY: Credit Check Did the Applicant meet the screening criteria? Criminal Check Did the Applicant meet the screening criteria? Is the Applicant listed n the IN Sheriffs' Sex & Vilent Offender Registry? Landlrd Reference Check Did the Applicant meet the screening criteria? Signature f Apprval:
7 LANDLORD REFERENCE CHECK TO: FROM: Shannn Glenn Apartments 280 Shamrck Curt Evansville, IN Phne: Phne: (812) Fax: Fax: (812) Applicant Name: Date f Birth: Scial Security Number: T Be Cmpleted By Office Staff Apartment Cmmunity Applying Fr: Shannn Glenn Apartments Reference Perfrmance Methd: Telephne Persn-t-Persn Written Name f Persn Perfrming Reference Check: Previus Address: Landlrd Name: Phne Number: Fax Number: Type f Residence: Apartment 1.1 Hme Other Type f Landlrd: Management C. Real Estate C. L Private Owner T Be Cmpleted By Current r Previus Landlrd N, the named abve has NOT rented frm my agency. Yes, the named abve has rented frm my agency. 1. Dates f Occupancy: Frm: T: 2. Mnthly Rent Amunt: 3. N. f Occupants: 4. N. f Late Payments: 5. N. f Returned Checks: 6. N. f Disturbance Cmplaints: 7. N. f Times Plice Called: Page 1 f 2
8 YES NO Did the resident, family r guests damage the prperty? 0 0 Did the resident pay fr the damages? 0 Did the resident vilate the lease agreement in any way? Li Did the resident vilate any f yur huse rules in any way? Did the resident give prper ntice fr vacating the unit? Wuld yu rent t this individual again? Did the resident have any pets? 0 Additinal Cmments: Signature f Persn Supplying this Infrmatin Date RELEASE: I hereby authrize the release f the requested infrmatin. Infrmatin btained under this cnsent is limited t infrmatin that is n lder than 12 mnths. There are circumstances that wuld require the wner t verify infrmatin that is up t 5 years ld, which wuld be authrized by me n a separate cnsent attached t a cpy f this cnsent. Applicant/Tenant Signature Date NOTE TO APPLICANT/TENANT: Yu d nt have t sign this frm if either the requesting rganizatin r the rganizatin supplying the infrmatin is left blank PENALTIES FOR MISUSING THIS CONSENT: Title 18, Sectin 1001 f the U.S. Cde states that a persn is guilty f a felny fr knwingly and willingly making false r fraudulent statements t any department f the United States Gvernment. HUD and any wner (r emplyee f HUD r wner) may be subject t penalties fr unauthrized disclsures r imprper uses f infrmatin cllected based n the cnsent frm. Use f the infrmatin cllected based n this verificatin frm is restricted t the purpse cited abve. Any persn wh knwingly r willingly requests, btains, r disclses any infrmatin under false pretenses cncerning an applicant r participant may be subject t a misdemeanr and fined nt mre than $5,000. Any applicant r participant affected by negligent disclsure f infrmatin may bring civil actin fr damages and seek ther relief, as may be apprpriate, against the fficer r emplyee f HUD r the wner respnsible fr the unauthrized disclsure f imprper use. Penalty prvisins fr misusing the scial security number are cntained in the Scial Security Act at **208 (a) (6), (7) and (8).** Vilatins f these prvisins are cited as vilatins f 42 USC **408 (a) (6), (7) and (8).** Page 2 f 2
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 informationWestern 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 informationPERKINS 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 informationKaruk 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 informationHOUSEHOLD MEMBERS (please include head of household)
Date: ST. TAMMANY PARISH COMMUNITY ACTION AGENCY WAP Applicatin Last Name: First Name: Address: City: Zip Cde Telephne Number: Cell: MARITAL STATUS: Single (Never Married) Married Separated Divrced Widwed
More informationWorkforce Housing Qualification Guidelines
Wrkfrce Husing Qualificatin Guidelines Prime Real Estate, LLC cmplies with the Federal Fair Husing Act. Prime Real Estate, LLC des nt discriminate n the basis f race, clr, religin, natinal rigin, sex,
More informationOAKVIEW 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 informationNotice all applicants applying to live at NeighborWorks Alaska s Apartments
Ntice all applicants applying t live at NeighbrWrks Alaska s Apartments Effective September 1, 2016, All f NeighbrWrks Alaska s prperties listed belw will be smke free. In rder t eliminate the knwn health
More informationMentoring & Coaching
Mentring and Caching Interventin Preventin Prgrams Mentring Caching Mentr Applicatin Prcess Rles and Respnsibilities Our Mentring Caching Prgram strives t develp a strng bnd and a cnsistent relatinship
More informationVOLUNTEER 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 informationGuide 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 informationCOLLEGE HOUSING NORTHWEST RENTAL APPLICATION
COLLEGE HOUSING NORTHWEST RENTAL APPLICATION Cllege Husing Nrthwest is a nt-fr-prfit rganizatin funded in 1969 by students t supprt students in the areas f husing, academic success, and persnal develpment.
More informationMod Rehab Annual Review forms packet
Md Rehab Annual Review frms packet Indicates frms included in the Md Rehab Annual Review frms packet. Agencies r applicants supply the ther materials listed. SRO Persnal Declaratin SHA Release f Infrmatin
More informationREPRESENTATIVE 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 informationaddress: Driver license number: Date of birth: Occupation:
MEMBERSHIP APPLICATION PRIMARY MEMBER INFORMATION Name: Scial security Member Number: Hme phne: Cell phne: Business phne: Mther s Maiden Name: Security passwrd: Mailing address: City: State: ZIP Cde: Street
More informationPrivacy 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 informationApplication 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 informationAPPLICATION TO CHANGE OR ADD A CORPORATE OFFICER OF A CORPORATION OR MEMBER / MANAGER OF A LIMITED LIABILITY COMPANY. General Instructions
NEVADA STATE CONTRACTORS BOARD 2310 Crprate Circle, Suite 200, Hendersn Nevada, 89074 (702) 486-1100 Fax (702) 486-1190 Investigatins (702) 486-1110 5390 Kietzke Lane, Suite 102, Ren, Nevada, 89511 (775)
More informationTenancy 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 informationAPPLICATION 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 informationAll 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 informationInstruction 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 informationAPPLICATION 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 informationRenewal of Manager s Certificate
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
More informationVerification Worksheet- V1 DIRECTIONS 2016 INCOME TAX FILER DIRECTIONS:
2018-2019 Verificatin Wrksheet- V1 DIRECTIONS 2016 INCOME Yur applicatin was selected by the U.S. Dept. f Educatin fr review in a prcess called "verificatin". Yu must submit the last 3 pages f this verificatin
More informationApplication 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 informationDetails of Rate, Fee and Other Cost Information
Details f Rate, Fee and Other Cst Infrmatin Accunt terms are nt guaranteed fr any perid f time. All terms, including fees and APRs fr new transactins, may change in accrdance with the Credit Card Agreement
More informationCRG 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 informationThe Safety Net Foundation
The Safety Net Fundatin Instructins fr Kineret (anakinra) and Sensipar (cinacalcet HCl) Instructins The Safety Net Fundatin prvides temprary prduct assistance t financially needy patients wh meet predetermined
More informationHALE MAHAOLU HOUSING APPLICATION
HALE MAHAOLU HOUSING APPLICATION General Infrmatin: Hale Mahalu is a private, nnprfit husing crpratin that develps, wns and manages lw- and mderate-incme husing units thrughut Maui Cunty fr families, senirs,
More informationARIZONA FIRE DISTRICT ASSOCIATION FINANCIAL PROCEDURES POLICY
FINANCIAL PROCEDURES POLICY 1. PURPOSE The purpse f these Financial Prcedures is t prvide cnsistent applicatin f cnduct and prper internal cntrls t safeguard the assets f the Arizna Fire District Assciatin
More informationASETS APPLICATION. Are you receiving Income Support. Name Age Date of Birth Relationship Living with me. Emergency
Inuvialuit Reginal Crpratin Human Resurces, Educatin & Training Department ASETS Prgram 867-777-7091 Tll Free: 1-855-777-7011 Fax: 867-777-4506 CRF EI PERSONAL IDENTIFICATION SIN Surname ASETS APPLICATION
More informationPRIMERO RE-2 SCHOOL DISTRICT SUPERINTENDENT/PRINCIPAL APPLICATION. Mission
Missin The Primer RE-2 Schl District shall strive t prvide a safe envirnment, fr all students and staff and meaningful pprtunities and innvative educatinal prgrams fr all students s that they reach their
More informationNTA LIFE CLAIM PACKET
PROTECTING THE HEART OF OUR COMMUNITY NTA LIFE CLAIM PACKET Included in this packet yu will find: 1. Instructins fr Cmpleting the Health, Accident, and Disability Claim Frm 2. Health, Accident, and Disability
More informationAlabama Department of Revenue Driver Or Vehicle Data Information Request
Alabama Interactive, Inc 104 Nrth Jacksn Street Mntgmery, AL 36104 (866) 353-EGOV www.alabamainteractive.rg subscriptins@alabamainteractive.rg Alabama Department f Revenue Driver Or Vehicle Data Infrmatin
More informationEmployment 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 informationPLAN 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 informationTown of Palm Beach Retirement System. Deferred Retirement Option Plan (DROP) Policies and Information for Participants
Twn f Palm Beach Retirement System Deferred Retirement Optin Plan (DROP) Plicies and Infrmatin fr Participants Twn f Palm Beach Retirement System Deferred Retirement Optin Plan (DROP) Plicies and Infrmatin
More informationTWU OFFICE OF RESEARCH & SPONSORED PROGRAMS INSTRUCTIONS FOR USING THE TWU PROPOSAL APPROVAL ROUTING FORM
TWU OFFICE OF RESEARCH & SPONSORED PROGRAMS INSTRUCTIONS FOR USING THE TWU PROPOSAL APPROVAL ROUTING FORM Phne: (940) 898-3375 Website: http://www.twu.edu/research/ WHEN TO SUBMIT THROUGH RESEARCH & SPONSORED
More informationConsent to Request Consumer Report & Investigative Consumer Report Information
Cnsent t Request Cnsumer Reprt & Investigative Cnsumer Reprt Infrmatin Applicant's First Name r Initial Last Name I understand that [Cmpany Name] ( COMPANY ) will utilize the services f Sterling InfSystems
More informationTERMS 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 informationHabitat for Humanity of Greater Memphis Family Selection Requirements
Habitat fr Humanity f Greater Memphis Hmewnership Prgram Applicatin Package Revised Dec 2016 Habitat fr Humanity f Greater Memphis Family Selectin Requirements First, families are chsen wh are hmeless
More informationMinnesota VOTER REGISTRATION
Minnesta VOTER REGISTRATION These resurces are current as f 12/1/18. We d ur best t peridically update these resurces and welcme any cmments r questins regarding new develpments in the law. Please email
More informationThere are two ways to submit your banking information for direct deposit into your personal bank account:
Cmpleting Yur Master Student Financial Assistance (MSFAA) Agreements Alberta and Canada have lifetime Master Student Financial Assistance Agreements (MSFAAs) that will cver yu fr all f the time yu are
More informationEMPLOYMENT 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 informationPolicy on Requesting Reasonable Accommodations from the Zoning Code
Plicy n Requesting Reasnable Accmmdatins frm the Zning Cde Backgrund The Americans with Disabilities Act (ADA), as amended, is a federal anti-discriminatin statute designed t remve barriers that prevent
More informationNational Background Check Permission Forms
Natinal Backgrund Check Permissin Frms Purpse: Frm t btain a backgrund web search fr an emplyee/vlunteer wh has resided utside the state f Indiana in the previus ten years. 1. Emplyee/vlunteer must cmplete
More informationC>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 informationENTERPRISE INCOME VERIFICATION (EIV) SECURITY/USER POLICY. Our Business is You. Purpose:
Our Business is Yu ENTERPRISE INCOME VERIFICATION (EIV) SECURITY/USER POLICY Purpse: The purpse f this plicy is t prvide instructin and infrmatin t staff, auditrs, cnsultants, cntractrs and tenants n the
More informationTerms 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 informationAPPLICATION 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 informationCAREVEST 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 informationFinancial 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 informationSTATE OF NEW YORK MUNICIPAL BOND BANK AGENCY
STATE OF NEW YORK MUNICIPAL BOND BANK AGENCY Recvery Act Bnd Prgram Written Prcedures fr Tax Cmpliance and Internal Mnitring, adpted September 12, 2013 PROGRAM OVERVIEW The State f New Yrk Municipal Bnd
More informationQuality Assurance Program Independent Student Verification Worksheet
2015-16 Quality Assurance Prgram Independent Student Verificatin Wrksheet QAIVER Yur applicatin was selected fr review in a prcess called verificatin. In this prcess, Temple University will be cmparing
More informationAPPLICATION FOR CONCESSIONAL FEES
APPLICATION FOR CONCESSIONAL FEES Family Name: Family Number: Students Enrlled at Sacred Heart Cllege: Name Year Level Checklist I/We have fr all carers: Cmpleted and Signed this Applicatin Attached the
More informationCaregiver/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 informationThe 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 informationHawaii Division of Financial Institutions 2018 Renewal Checklist
Hawaii Divisin f Financial Institutins 2018 Renewal Checklist Instructins Renewal requests must be submitted thrugh by the date specified by yur state regulatr(s). Click here t review all renewal deadlines,
More informationRelocation/Moving Procedures for New Employees
Relcatin/Mving Prcedures fr New Emplyees Purpse T prvide guidelines and restrictins regarding thse cases where relcatin csts are necessary fr an individual t accept emplyment with the University and t
More informationPrivate Lesson Paperwork Checklist
2018-19 Private Lessn Paperwrk Checklist Please cmplete the fllwing frms t be eligible t teach as a Private Lessn Instructr fr 2018/19. General Infrmatin Frm Cnsent t Perfrm Criminal Histry Backgrund Check
More informationVerification Worksheet
2015-2016 Verificatin Wrksheet Independent Student Tracking Grup V1 STAFF USE ONLY Frm Received by Date Yur 2015 2016 Free Applicatin fr Federal Student Aid (FAFSA) was selected fr review in a prcess called
More informationVA Mortgage Lender License New Application Checklist (Company)
VA Mrtgage Lender License New Applicatin Checklist (Cmpany) CHECKLIST SECTIONS General Infrmatin License Fees Requirements Cmpleted in Requirements/Dcuments Upladed in Requirements Submitted Outside f
More informationCONSENT 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 informationAttachment #3 To Report No. HC HALTON COMMUNITY HOUSING CORPORATION
Attachment #3 T Reprt N. HC-09-09 HALTON COMMUNITY HOUSING CORPORATION Date f issue: Dcument number: Revisin: 2 PAGE 1 OF 6 Apprval: Title: MANAGER, HOUSING OPERATIONS 1.0 Purpse The purpse f the Plicy
More informationMorgan 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 informationBACKGROUND CHECK DISCLOSURE DOCUMENT
NOTICE TO SAFESTHIRES CLIENT: The sample dcuments included in this PDF shuld NOT be cnstrued as legal advice, guidance r cunsel. Emplyers shuld cnsult their wn attrney abut their cmpliance respnsibilities
More informationGrant 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 informationWhat credit related information do we collect and hold and how do we collect it?
In this Credit Reprting Plicy, ORIX, we, us and ur mean ORIX Australia Crpratin Limited and ur related cmpanies. Thse related cmpanies may als have their wn privacy r credit reprting plicies which set
More informationDATA PROTECTION POLICY FOR PUPILS AND PARENTS
DATA PROTECTION POLICY FOR PUPILS AND PARENTS This Plicy is relevant t the whle schl including EYFS Cntents 1.0 Intrductin 2.0 Respnsibility fr data prtectin 3.0 Types f persnal data prcessed by the schl
More informationPROOF OF CLAIM AND RELEASE
Deadline fr Submissin: June 9, 2018 PROOF OF CLAIM AND RELEASE IF YOU PURCHASED THE COMMON STOCK OF MAGNACHIP SEMICONDUCTOR CORP. ( MAGNACHIP ) BETWEEN FEBRUARY 1, 2012 AND MARCH 11, 2014, INCLUSIVE (TH
More informationREFERENCE 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 informationInformation Package CAFETERIA 125 PLANS
Infrmatin Package CAFETERIA 125 PLANS Shaffer Insurance Services, Inc. Benefits Divisin 902 E. Ave Q-9 Palmdale Ca. 93550 Tll Free (866) 412-5872 Office Tel (661) 575 9331 Fax (661) 280 2016 Sectin 125
More informationSummit Asset Managers Limited
Irish Infrastructure Trust Privacy Ntice Intrductin This ntice sets ut details f hw and why Summit Asset Managers Limited, f Beresfrd Curt,, Dublin 1, Ireland, acting n behalf the Irish Infrastructure
More informationPROOF OF CLAIM AND RELEASE
Deadline fr Submissin: FEBRUARY 16, 2015 Tel.: 866-274-4004 Fax: 610-565-7985 inf@strategicclaims.net PROOF OF CLAIM AND RELEASE IF YOU PURCHASED OR OTHERWISE ACQUIRED AMERICAN DEPOSITORY SHARES ( ADS
More informationJOHN 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 informationQuality 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 informationPAYMENT BY CARD TERMS & CONDITIONS
PAYMENT BY CARD TERMS & CONDITIONS Versin 2.0 - June 2013 Effective frm 1 st June 2013 Issued n 1 st June 2013 Terms & Cnditins fr use f Credit/Debit card fr Payments (POS) Intrductin This Service is ffered
More informationEuropa 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 informationPetition to Rezone Packet
Petitin t Rezne Packet Cntents Prcedure and Required Materials Petitin Applicatin Affidavit Permissin t Reprduce Cnfirmatin f Ownership by Owner; and Authrizatin fr Agent r Petitiner, when a different
More informationCustomer 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 informationChecking 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 informationThe Application is due by Mail: Friday, April 27, 2018 The scholarship applications must be mailed to:
Dear Emma Nylen Schlarship Applicant, Enclsed, yu will find the fllwing: 1) Eligibility Requirements; and 2) Emma Nylen Schlarship Prgram Applicatin Apprximately 20-50 schlarships are prvided thrugh the
More informationGolf Relief and Assistance Fund Application
Glf Relief and Assistance Fund Applicatin Eligibility The Glf Relief and Assistance Fund is designed t supprt individuals wrking in the glf industry and their husehld family members wh have been impacted
More informationA-1110 Wien. Privacy Notice
Eurfins Lebensmittelanalytik Tel. +43 (1) 944 33 44-0 ffice@eurfins.at www.eurfins.at Privacy Ntice Table f cntents 1 Cntrller infrmatin... 2 2 What infrmatin shuld yu give Eurfins?... 2 3 Why d we use
More informationSpecial Conditions Form
2019-2020 Special Cnditins Frm Cntact Infrmatin www.twsn.edu/finaid finaid@twsn.edu 410-704-4236 If yur family has experienced a majr reductin in incme, the Financial Aid Office may be able t reevaluate
More informationILLINOIS 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 informationMemorandum. Employees, Retirees and Survivors. Sarah Kloos, Director of Personnel. Date: September 22, Transition to GIC Health Benefits
Memrandum T: Frm: Emplyees, Retirees and Survivrs Sarah Kls, Directr f Persnnel Date: September 22, 2011 Subject: Transitin t GIC Health Benefits Pursuant t Chapter 67 f the Acts f 2007, and after cnsultatin
More informationPROOF OF CLAIM AND RELEASE
PROOF OF CLAIM AND RELEASE Deadline fr Submissin: July 11, 2015 IF YOU PURCHASED THE COMMON STOCK OF, INC., ( ) DURING THE PERIOD FROM NOVEMBER 14, 2013 THROUGH APRIL 9, 2014, INCLUSIVE (THE CLASS PERIOD
More informationPROCESS FOR NATIONAL CAPITOL AREA GARDEN DISTRICTS, CLUBS AND COUNCILS CHOOSING TO FILE FOR 501(C)3 GROUP EXEMPTION
PROCESS FOR NATIONAL CAPITOL AREA GARDEN DISTRICTS, CLUBS AND COUNCILS CHOOSING TO FILE FOR 501(C)3 GROUP EXEMPTION What is a grup exemptin letter? The IRS smetimes recgnizes a grup f rganizatins as tax-exempt
More informationBECCLES 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 informationMICRO 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 informationThe Supplemental Nutrition Assistance Program (SNAP) used to be called Food Stamps. You can show your SNAP card or show an award letter that has:
SNAP (Fd Stamps) The Supplemental Nutritin Assistance Prgram (SNAP) used t be called Fd Stamps. Yu can shw yur SNAP card r shw an award letter that has: Name f the prgram Name f the participant Address
More informationQueen s University Housing & Hospitality Services Residence Agreement. Graduate Students - Confederation Place Hotel
Queen s University Husing & Hspitality Services Residence Agreement Graduate Students - Cnfederatin Place Htel All students are expected t regulate their cnduct accrding t reasnable standards f curtesy
More informationBROCKTON AREA MULTI-SERVICES, INC. ORGANIZATION AND POLICY GUIDE
Page 1 f 6 Subject: Plicy and Prcedure Regarding Prgressive Disciplinary Actin Plicy Date Develped: 7/01/06 Date(s) Reviewed/Revised: 5/4/10 PURPOSE: T define BAMSI s plicy n Prgressive Disciplinary Actin
More informationPHILADEPHIA PROMOTING HEALTHY FAMILIES AND WORKPLACES ORDINANCE (PAID SICK LEAVE LAW)
PHILADEPHIA PROMOTING HEALTHY FAMILIES AND WORKPLACES ORDINANCE (PAID SICK LEAVE LAW) Eligibility Wrkers emplyed in Philadelphia fr at least 40 hurs in a calendar year (January 1 t December 31) will accrue
More informationCharter Township of Oakland 4393 Collins Road, Rochester, MI Public Summary of FOIA Procedures and Guidelines
Charter Twnship f Oakland 4393 Cllins Rad, Rchester, MI 48306 248-651-4440 Public Summary f FOIA Prcedures and Guidelines Cnsistent with the Michigan Freedm f Infrmatin Act (FOIA), Public Act 442 f 1976,
More informationCertification of Beneficial Owner(s)
GENERAL INSTRUCTIONS T help the gvernment fight financial crime, federal regulatin requires certain financial institutins t btain, verify, and recrd infrmatin abut the beneficial wners f legal entity custmers.
More informationSpecial Conditions Form
2017-18 Special Cnditins Frm Cntact Infrmatin www.twsn.edu/finaid finaid@twsn.edu 410-704-4236 If yur family has experienced a majr reductin in incme, the Financial Aid Office may be able t reevaluate
More informationHawaii Division of Financial Institutions 2019 Renewal Checklist
Hawaii Divisin f Financial Institutins 2019 Renewal Checklist Instructins Renewal requests must be submitted thrugh by the date specified by yur state regulatr(s). Click here t review all renewal deadlines,
More information