Cardholder Signature Sample Clauses

Cardholder Signature. Our Vision: To inspire and empower our community to prosper through innovation RESPECT SUCCESS CREATIVITY
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Cardholder Signature. Do you own an ECG Transmitter? ❑ Yes (Please describe: ) ❑ No (❑ I am interested in purchasing one) Terms are payable upon receipt. Finance charges of 1.5% per month (18% Annual) will be assessed on any balance unpaid after 30 days. Past due accounts are subject to credit restrictions and credit holds. Payment may be made by business check, Visa, MasterCard and Discover. There is a returned check fee of $25.00. By signing this agreement, I personally consent to pay any outstanding debt, including collection and/or any reasonable legal fees. I have provided the correct information above and I agree to the terms and conditions contained herein. Owner/Principal Signature: Date: Please e-mail or fax this form to: Institute of Veterinary Specialists xxxxxxx@xxxxxxxx.xxx Phone: 0-000-000-0000 Fax: 0-000-000-0000
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Cardholder Signature. In the event that the scheduled payment is not collected we will attempt automatic collection up to two additional times within 10 business days.
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Cardholder Signature. I declare that I have read and understood the booking conditions below, the payment and tariffs. I agree to respect said conditions and confirm that the information provided is accurate.
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Cardholder Signature. Scotiabank Cardholder Agreementv2.0 I hereby agree that I have read and understood the rules and procedures outlined in the UFV Purchase Card Program Handbook and will adhere to them. Misuse of the Card may result in card privileges being terminated.
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Cardholder Signature. 6.1.2 a brief description of the goods returned, services terminated or canceled, or refund or adjustment made (in sufficient detail to identify the original purchase transaction);
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Related to Cardholder Signature

  • Your Signature (Sign exactly as your name appears on the face of this Note) Signature Guarantee*: _________________________ * Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor acceptable to the Trustee).

  • SUBSCRIBER SIGNATURE The undersigned, desiring to subscribe for the number of Shares of MAYFLOWER INVESTMENT GROUP, INC. (the “Company”) as is set forth below, acknowledges that he/she has received and understands the terms and conditions of the Subscription Agreement attached hereto and that he/she does hereby agree to all the terms and conditions contained therein.

  • Contract Signature If the Original Form of Contract is not returned to the Contract Officer (as identified in Section 4) duly completed, signed and dated on behalf of the Supplier within 30 days of the date of signature on behalf of DFID, DFID will be entitled, at its sole discretion, to declare this Contract void. No payment will be made to the Supplier under this Contract until a copy of the Form of Contract, signed on behalf of the Supplier, is returned to the Contract Officer.

  • Witness Signature 4. PARENT/GUARDIAN CONSENT: (for applicants under 18 years) – I hereby certify and decree that all the information contained in the declarations above is true and accurate Print Name:................................................................... Signature …………………………………………....……... Relationship to applicant ……………………………… Phone Contact ……………………................................... Address …………………………………………………………………….....................................................................

  • Signature Signature For the participant For the institution Xxxxxx Xxxxx prof. Ing. arch. Xxxxxx Xxxxxxx, PhD. Vice-xxxxxx for International Relations and Public Relations, based on the procuration Annex I

  • Employee Signature Employee ID: Telephone No: Employee Address: Work Location:

  • Facsimile and Email Signatures The use of facsimile signatures and signatures delivered by email in portable document format (.pdf) affixed in the name and on behalf of the transfer agent and registrar of the Partnership on certificates representing Common Units is expressly permitted by this Agreement.

  • Participant Signature Ratification, Acceptance(A), Approval(AA), Accession(a)

  • Facsimile or .pdf Signature This Agreement may be executed by facsimile or .pdf signature and a facsimile or .pdf signature shall constitute an original for all purposes.

  • Signature This Section 2 and the exercise form attached hereto set forth the totality of the procedures required of the Holder in order to exercise this Purchase Warrant. Without limiting the preceding sentences, no ink-original exercise form shall be required, nor shall any medallion guarantee (or other type of guarantee or notarization) of any exercise form be required in order to exercise this Purchase Warrant. No additional legal opinion, other information or instructions shall be required of the Holder to exercise this Purchase Warrant. The Company shall honor exercises of this Purchase Warrant and shall deliver Shares underlying this Purchase Warrant in accordance with the terms, conditions and time periods set forth herein.

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