Member Signature. The undersigned Member, agreeing to be bound by the foregoing executes this Agreement as of the 30th day of June, 2014.
Member Signature. Sign and date the form before a Notary Public at the bank. Forms that are not notarized will not be acceptable.
Member Signature. Data Collection Information As participant in a Federal utilities financing program, Mor-Gran-Sou Electric Cooperative, Inc., is required to identify and document as accurately as possible, the racial/ethnic data on the eligible population in our service area. We would appreciate your checking the appropriate group listed below and return this form. Please note your response is optional. The information you provide will be used only for FEDERAL GOVERNMENT REPORTING PURPOSES. If you have any questions concerning this, please contact Mor-Gran-Sou Electric at the address listed above. American Indian or Alaska Native Black or African American Asian Native Hawaiian or Other Pacific Islander White Hispanic or Latino Not Hispanic or Latino Capital Credit Refund For Capital Credit refund purposes, please complete the following: Applicant date of birth: Joint Applicant date of birth: Joint Applicant’s Name: PLEASE RETURN THIS FORM TO THE MOR-GRAN-SOU ADDRESS ABOVE OR BY EMAIL AT XXXX@XXXXXXXXXX.XXX.
Member Signature. The undersigned Member, agreeing to be bound by the foregoing executes this Agreement as of the 16th day of December, 2015. CLASS A MEMBER: BRG CHESHIRE, LLC, a Delaware limited liability company By: Bluerock Residential Holdings, LP, a Delaware limited partnership, its Sole Member By: Bluerock Residential Growth REIT, Inc., a Maryland corporation, its General Partner By: /s/ R. Xxxxx Xxxxxx
Member Signature. The undersigned Member, agreeing to be bound by the foregoing executes this Agreement as of the 20th day of November, 2015. CLASS A MEMBER: BRG DOMAIN PHASE 1, LLC, a Delaware limited liability company By: Bluerock Residential Holdings, LP, a Delaware limited partnership, its Sole Member By: Bluerock Residential Growth REIT, Inc., a Maryland corporation, its General Partner By: /s/ Mxxxxxx Xxxxx Name: Mxxxxxx X. Xxxxx Title: Chief Operating Officer CLASS B MEMBER: BLUEROCK SPECIAL OPPORTUNITY + INCOME FUND II, LLC, a Delaware limited liability company By: BR SOIF II Manager, LLC, a Delaware limited liability company By: /s/ Mxxxxxx Xxxxx Name Mxxxxxx X. Xxxxx Title: Authorized Signatory SCHEDULE I
Member Signature. By signing below I agree to participate as a Member of the Westlake Recovery House, agree to abide by all of the house rules, regulations, policies, terms and conditions within this living contract and acknowledge that I have read over this entire document. I certify that the information contained in this document is true. I accept the above conditions set forth for membership to the Westlake Recovery House, and agree to abide by said conditions as a member resident. Printed Name of Member: Member Signature: Date: Printed Name of House Representative: House Representative Signature: Date:
Member Signature. AQuA Ltd. SIGNATURE: Name: Name: JMC Wrigley Title: Title: Executive Director Signature: Signature: Date: Date: Telephone: Telephone:+00 000 000 0000 E-mail: E-mail:xxxxxx@xxxxxxxxxxxxxxxxxx.xxx Member Information: Company Name: _ Mailing Address: City, (State): Postal Code: Country: VAT Number: URL: Primary Contact (all notices under this Agreement shall be sent to the Primary Contact): Primary Contact Name: Title: E-mail: Mailing Address: City, (State): Postal Code: Country: Appendix 1 - AQuA Member: Criteria, rights and obligations. Membership Criteria The Member must be interested in the development of quality mobile apps and supportive of AQuA’s aims and objectives and have a clear and established identity and contact details. This identity must be supported by items such as a website, publisher ID, LinkedIn, Facebook, Twitter etc.
Member Signature. I hereby certify that, to the best of my knowledge, the information provided in this Application is true. I agree to abide by Noble’s Terms and Conditions for Service as listed in the Net Billing Schedule (NB-1) and Interconnection Agreement. Return the Certificate of Completion when the Small Generating Facility has been installed. Signed: Date: Contingent Approval to Interconnect the Small Generating Facility (For Noble REMC use only) Interconnection of the Net Billing Facility is approved contingent upon the Terms and Conditions for Service as listed in the Net Billing Schedule (NB-1) and Noble’s Interconnection Agreement. A Certificate of Completion must also be submitted by member to Noble REMC. Company Signature:
Member Signature. Date: This form must be signed. Completed form can be returned by mail or delivered to one of our branch locations. Argent Credit Union * PO Box 72, Chesterfield, VA 23832 * xxx.xxxxxxxx.xxx
Member Signature. Date X Joint Owner Signature Date
