Declaration and Consent Sample Clauses

Declaration and Consent. I declare by my signature; To have read, understood and agreed to the Xxxxxxx Xxxxx Xxxxxxx Investment Limited Retail Client Agreement and such supplementary documents listed in 1.3; as detailed above. Client Signature Date: If joint Account
AutoNDA by SimpleDocs
Declaration and Consent. I/We have read and consent to the above Client Agreement and confirm the issue and receipt of the IDD. I/We hereby authorise the transfer of information between such third parties, as described above, on a confidential basis when warranted. I/We agree that the Client Agreement will come into effect from the date of their receipt. I/We authorise illingworths insurance & financial services to act on my/ our behalf in obtaining the mortgage loan and/or any required non-investment insurances. Signature 1 Print Name ………………………….. ………………………….. Signature 2 Print Name ………………………….. …………………………..
Declaration and Consent. Part A – To be completed by the individual submitting this form I have previously been a client of a rural financial counselling service: Yes/No If yes, name of service provider and counsellor: ………………………….……………………………………….. ………………………………………………………………………………………………………………………………………………. I have read and understood, and agree to, the conditions of service contained in this Client Service Agreement and Declaration. I have also received and understood the Privacy Notice. I consent to the collection of my personal information, including any sensitive information, from myself and from other entities as described in the Privacy Notice and the use and disclosure for the purposes outlined in the Privacy Notice. Name: ……………………………………………………………………...………………………...………………………… Enterprise name: ................................................................................................................. Signature: …………………………………………………………………………....Date:……………………………….... Part B – To be completed by each of the Other Partner(s) (if any), whose personal information is or will be provided for the purposes of seeking support under the RFCS Programme I have received and understood the Privacy Notice. I consent to the collection of my personal information, including any sensitive information, from myself and from other entities for the purposes as described in the Privacy Notice. Name: ……………………………………………………………………...………………………...………………………. Signature: …………………………………………………………………………....Date:………………………………....
Declaration and Consent. (Check the appropriate box) — The additional policy fee is $100 I hereby certify: Insured Co-insured TOTAL PREMIUM (including $100 policy fee) $ • That I am a natural person residing in Canada and that I am capable of performing my regular duties. □ □ • That I am 18 years of age or older, but less than 71 years of age for life insurance, less than 65 years of age for disability insurance and/or critical illness insurance, and less than 60 years of age for unemployment insurance. □ □
Declaration and Consent. We take your privacy very seriously and will only use your personal information and data to administer the services we have agreed to provide you with, including but not limited to any products or contracts for investments, pensions or life cover you have made or entered into through our firm. By signing this Terms of Business you are confirming your agreement to these terms. Name Signature Date Client 1: Client 2: Autus is a trading style of Autus Lifetime Planning Limited, which is registered in England & Wales Number 8813223. Registered Offices: The Grange, Wheldrake Lane, Xxxxxxxxx, Xxxx, Xxxxx Xxxxxxxxx, XX00 0XX.
Declaration and Consent. You, or your decision maker, confirm that you have read this agreement or have had this agreement explained to you and agree that the information is true and correct and may be used by Patch DSS and their staff to provide appropriate support according to this agreement. Support List the name of the support. Description of support List the details of the support, including scope and volume. Price and payment information List the price of the support (e.g. per hour / per session / per unit) and whether NDIS funding for the support is managed by the Participant, Participant’s Nominee, the NDIA, or a Registered Plan Management Provider. How the support will be provided List how, when, where, and by whom the support will be provided. Xxxxx 0 Daily Personal Activates $52 Per Hour Plan Managed Domestic Assistance $49 Per hour Plan Managed Social and Community $52 Per Hour Plan Managed Yard and Maintenance $50 Per Hour Plan Managed ALL PARTIES AGREE TO THE TERMS AND CONDITIONS OF THIS AGREEMENT Name of [participant/participant’s representative] Signature of [participant/participant’s representative] X Date: Name of authorised person from Patch Disability Support Services: Signature of authorised person from Patch Disability Support Services
Declaration and Consent. You, or your decision maker, confirm that you have read this agreement or have had this agreement explained to you and agree that the information is true and correct and may be used by Adventure Ability Services and their support workers to provide appropriate support according to this agreement. Support List the name of the support. Description of support List the details of the support. Scope and volume. Price and payment information According to the NDIS price list. How the support will be provided Place, Time. ALL PARTIES AGREE TO THE TERMS AND CONDITIONS OF THIS AGREEMENT Name of [participant/participant’s representative] Signature of [participant/participant’s representative] Signature: Name: Date: Signature: Name: Xxxxx Xxxxxxxxxx
AutoNDA by SimpleDocs
Declaration and Consent. With due regard to the contents of POPI and the definitions contained above, I declare and confirm that-
Declaration and Consent. You, or your decision maker, confirm that you have read this agreement or have had this agreement explained to you and agree that the information is true and correct and may be used by Adventure Ability Services and their support workers to provide appropriate support according to this agreement. Support List the name of the support. Description of support List the details of the support. Scope and volume. Price and payment information According to the NDIS price list. How the support will be provided Place, Time. ALL PARTIES AGREE TO THE TERMS AND CONDITIONS OF THIS AGREEMENT Name of [participant/participant’s representative] Signature of [participant/participant’s representative] Signature: ______________________ Name: ______________________ Date: ______________________ Signature: ______________________ Name: Xxxxx Xxxxxxxxxx Date:

Related to Declaration and Consent

  • AUTHORIZATION AND CONSENT The Government has given its authorization and consent for all use and manufacture of any invention described in and covered by a patent of the United States in the performance of this Agreement or any part hereof or any amendment hereto or any subcontract hereunder (including any lower-tier subcontract) which is expected to exceed $100,000.

  • ACKNOWLEDGEMENT AND DECLARATION I/We sign this declaration as the customer:-

  • Informed Consent Both of us have reviewed this Agreement with independent legal counsel. We understand the content, legal effect, and consequences of this Agreement, and we are entering into this Agreement voluntarily, free from duress, fraud, undue influence, or coercion of any kind.

  • Powers, xxxxx and consents 1.1 It is duly incorporated under the law of England and Wales and has the corporate power to own its assets and to carry on the business which it conducts or proposes to conduct.

  • Your Consent By using any of the Services, you agree to this Privacy Policy and consent to the collection and use of information and/or data contemplated hereby. If you do not consent to the terms herein, do not use the Services. This is our entire and exclusive Privacy Policy and it supersedes any earlier version. To withdraw consent (which can happen at any time) and have data deleted, or data corrected, please contact call at +0 000 000-0000. We may change this Privacy Policy by posting a new version of this Privacy Policy on our Website or through the Mobile App, and it is your responsibility to review this policy periodically. When we do change the policy, we will also revise the “Revised” date at the end of the Privacy Policy and may notify you or post a message on the Website and/or through the Mobile App. Your continued use of the Website or the Mobile App constitutes your agreement to this Privacy Policy, as amended from time to time. By accessing, browsing, and using the Website or Mobile App, you agree that you have read, understood, and accept this Agreement, as may be amended from time to time. Please read it very carefully and let us know if you have any questions. If you do not agree or consent to any of the terms herein, do not use the Services.

  • AGREEMENTS AND DECLARATIONS 6.1 It is agreed between the Landlord and the Tenant that if at any time:

  • AMENDMENTS TO APPLICATION AND AGREEMENT; WAIVERS A. This Agreement may not be modified or amended except by an instrument or instruments in writing signed by all of the Parties and after completing the requirements of Section

  • CERTIFICATION AND LICENSES CONTRACTOR shall be certified by the California Department of Education (hereinafter referred to as “CDE”) as a nonpublic, nonsectarian school/agency. All nonpublic school and nonpublic agency services shall be provided consistent with the area of certification specified by CDE Certification and as defined in California Education Code, section 56366 et seq and within the professional scope of practice of each provider’s license, certification and/or credential. A current copy of CONTRACTOR’s nonpublic school/agency certification or a waiver of such certification issued by the CDE pursuant to Education Code section 56366.2 must be provided to LEA on or before the date this contract is executed by CONTRACTOR. This Master Contract shall be null and void if such certification or waiver is expired, revoked, rescinded, or otherwise nullified during the effective period of this Master Contract. Total pupil enrollment shall be limited to capacity as stated on CDE certification. In addition to meeting the certification requirements of the State of California, CONTRACTOR that operates a program outside of this State shall be certified or licensed by that state to provide, respectively, special education and related services and designated instruction and related services to pupils under the federal Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.). If CONTRACTOR is a licensed children’s institution (hereinafter referred to as “LCI”), CONTRACTOR shall be licensed by the state, or other public agency having delegated authority by contract with the state to license, to provide nonmedical care to children, including, but not limited to, individuals with exceptional needs. The LCI must also comply with all licensing requirements relevant to the protection of the child, and have a special permit, if necessary, to meet the needs of each child so placed. If the CONTRACTOR operates a program outside of this State, CONTRACTOR must obtain all required licenses from the appropriate licensing agency in both California and in the state where the LCI is located. A current copy of CONTRACTOR’s licenses and nonpublic school/agency certifications, or a validly issued waiver of any such certification must be provided to LEA on or before the date this Master Contract is executed by CONTRACTOR. CONTRACTOR must immediately (and under no circumstances longer than three (3) calendar days) notify LEA if any such licenses, certifications or waivers are expired, suspended, revoked, rescinded, challenged pursuant to an administrative or legal complaint or lawsuit, or otherwise nullified during the effective period of this Master Contract. If any such licenses, certifications or waivers are expired, suspended, revoked, rescinded, or otherwise nullified during the effective period of this Master Contract, this Master Contract shall be null and void. Notwithstanding the foregoing, if current (re)certification documents are not available through no fault of the NPS/A, this Master Contract shall remain in effect until such documents are made available to the NPS/A, which shall in turn submit copies of same to the LEA within five (5) business days of receipt by the NPS/A. The NPS/A shall, within five (5) business days of any change in the status of its approved capacity to serve a specific number of pupils notify the LEA of the change.

  • Consent and Approval Such Party has sought or obtained, or, in accordance with this Agreement will seek or obtain, each consent, approval, authorization, order, or acceptance by any Governmental Authority in connection with the execution, delivery and performance of this Agreement, and it will provide to any Governmental Authority notice of any actions under this Agreement that are required by Applicable Laws and Regulations.

  • Authorization and payment If you use the card to purchase goods or services by instalments or to make payments on a recurring basis, you thereby authorize us to pay such instalments for you as they become due and you agree to make payment for each such instalment when we debit the same to your card account.

Time is Money Join Law Insider Premium to draft better contracts faster.