Authorizing Signature. Date: RECYCLED PARTS QUALITY ASSURANCE I agree to maintain the highest standards of Recycled Parts Quality Assurance by implementing and managing systems in the following key areas:
Authorizing Signature. Section Referee Administrator Signature for National or Area Referee Administrator Signature for Intermediate and Advanced Required USSF Authorizing Signature: State Referee Administrator Signature Return form and fees to: United States Soccer Federation Referee Department – AYSO Form 0000 X. Xxxxxxx Xxxxxx Xxxxxxx, XX 00000 Return form to: AYSO National Office Programs Department 00000 X. Xxxxxxx Xxx., Xxxxx 000 Xxxxxxxx, XX 00000 Last name First Name M I Address Social Security # City State Zip Phone ( ) email AYSO Referees: Section/Area/Region / /_ USSF Referees: State Association ATTENTION USSF REFEREES: Cross-certification to an AYSO Referee also requires completion of the AYSO Safe Haven Certification Course. Additionally, all AYSO referees must be approved by and registered with a local AYSO Region and must annually complete a Volunteer Application Form. Please contact your local AYSO Regional Commissioner to submit a Volunteer Application Form and arrange for completion of AYSO Safe Haven certification. Once approved by the R egion, please have the Regional Commissioner sign below. I verify that the above named person is an approved volunteer in Region # . Regional Commissioner Signature My certification level with (AYSO or USSF) is . I am currently a certified referee of either AYSO or USSF, but not both. I have been a referee in _(AYSO or USSF) since (date of first certification). I am requesting cross-certification from AYSO to USSF or from USSF to AYSO as a(n) referee.
Authorizing Signature. This authorization is to remain in full force and effect until LABBB and BANK have received written notice from me of its termination in such time and in such manner as to afford LABBB and BANK a reasonable opportunity to act on it. Employee Signature: Date For A123456789A 0123456789c 0100 ( A voided check or bank letter with your routing number and account number is required. ) Routing/Transit # (a 9-digit # always between these two marks) Checking Account # Check # (matches # in upper right hand of the check is not needed here)
Authorizing Signature. Pastor/Director The undersigned is authorized to sign as a legal representative on behalf of the church/organization. The undersigned authorizes that the church/organization has received and reviewed the Ministry Agreement and understands the commitments of the Ministry Agreement. The undersigned further certifies that all statements regarding the church/organization are true and complete. Signature: Date: Name: Email: Title:
Authorizing Signature. Section Referee Administrator Signature for National or Area Referee Administrator Signature for Intermediate and Advanced Required USSF Authorizing Signature: State Referee Administrator Signature Return form to: Xxx XxXxxxxxxxx - AYSO Section 8 Referee Administrator: xxxxxxxxxxxxxx@xxxxx.xxx Xxxxxx Xxxxxx - Michigan USSF State Referee Administrator: xxx@xxxxxxxxxxxx.xxx Return form to: Xxx XxXxxxxxxxx - AYSO Section 8 Referee Administrator: xxxxxxxxxxxxxx@xxxxx.xxx Xxxxxx Xxxxxx - Michigan USSF State Referee Administrator: xxx@xxxxxxxxxxxx.xxx Last name First Name M I Address Social Security # City State Zip Phone ( ) email AYSO Referees: Section/Area/Region / /_ USSF Referees: State Association ATTENTION USSF REFEREES: Cross-certification to an AYSO Referee also requires completion of the AYSO Safe Haven Certification Course. Additionally, all AYSO referees must be approved by and registered with a local AYSO Region and must annually complete a Volunteer Application Form. Please contact your local AYSO Regional Commissioner to submit a Volunteer Application Form and arrange for completion of AYSO Safe Haven certification. Once approved by the R egion, please have the Regional Commissioner sign below. I verify that the above named person is an approved volunteer in Region # . Regional Commissioner Signature My certification level with (AYSO or USSF) is . I am currently a certified referee of either AYSO or USSF, but not both. I have been a referee in _(AYSO or USSF) since (date of first certification). I am requesting cross-certification from AYSO to USSF or from USSF to AYSO as a(n) referee.
Authorizing Signature. Signature: Date: (Please do not print; your signature is required) (MM/DD/YYYY) DISCLOSURE REGARDING YOUR BACKGROUND INVESTIGATION US1 LOGISTICS, LLC or its affiliate companies (“the Company”) may obtain information about you for employment purposes through its contracted Third-party Verifier, WorkforceQA. Thus, you may be the subject of a “consumer report” and/or an “investigative consumer report” procured by a Consumer Reporting Agency (CRA). The report is an independent investigation of your background, which pursuant to Section 603 of the Fair Credit Reporting Act (FCRA) may include information regarding your character, general reputation, personal characteristics, or mode of living. The scope of the report may include information concerning your driving record, civil and criminal court records, education, credentials, identity, past addresses, Social Security Number, substance abuse testing results, Worker’s Compensation information, previous employment, and personal references. If you are denied employment as a result of information obtained from your background check, pursuant to the FCRA, the Company will furnish you with the required adverse communications, which include a copy of your background report, a copy of A Summary of Your Rights Under the Fair Credit Reporting Act, and instructions on how to dispute inaccurate information contained within the report. US1 LOGISTICS, LLC or its affiliate companies will procure the report from: CRA: ASURINT, Compliance Department ● P.O. Box 14730 ● Cleveland, OH 44145 ● (000) 000-0000 ● xx.xxxxxxx.xxx/Xxxxxxxxxx.xxxx US 1 LOGISTICS, LLC XXXXXX’s STATEMENT OF ON-DUTY HOURS (For Newly Hired Drivers)
Authorizing Signature. This authorization is to remain in full force and effect until LABBB and BANK have received written notice from me of its termination in such time and in such manner as to afford LABBB and BANK a reasonable opportunity to act on it. Employee Signature: Date For A123456789A 0123456789 0100 ( A voided check or bank letter with your routing number and account number is required. ) Routing/Transit # (a 9-digit # always between these two marks) Checking Account # Check # (matches # in upper right hand of the check is not needed here) xxx.xxxxx.xxx • 00 Xxxxxxxxx Xxxxxxxx, Xxxxxxx, Xxxxxxxxxxxxx 00000 • (000) 000-0000
