Family Accounts Sample Clauses

Family Accounts. All patients 18 and older must fill out and sign a Financial Agreement. The guarantor of the family account must sign a Financial Agreement. Anyone 18 and older will ultimately be personally responsible for themselves. DIVORCED PARENTS Co-pays for any services for dependents are due on date of service. Treatment plans are provided prior to appointments with estimated co-pays. If needed, a prior arrangement with a parent needs to be taken care of before the child’s appointment. Copays need to be paid in full at or before the child’s appointment.  This Financial Agreement will apply to all family members unless specified otherwise.  I grant my permission to you, or your assignee, to telephone me to discuss matters related to this form.  I have read the above conditions of treatment and payment, and agree to their content. Signature of Guarantor/Responsible Party : Date: Print Name: Family Relationship:  Parent  Spouse  Child XXXXX PEAK DENTAL
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Family Accounts 

Related to Family Accounts

  • New Entity Accounts The following rules and procedures apply for purposes of identifying U.S. Reportable Accounts and accounts held by Nonparticipating Financial Institutions among Financial Accounts held by Entities and opened on or after July 1, 2014 (“New Entity Accounts”).

  • Special Accounts 1. For the purposes of this Schedule:

  • Separate Accounts The trustee shall maintain within the trust fund a separate account for each Agricultural Contractor that signs the trust agreement to hold deposits made pursuant to this article.

  • Personal Accounts With a personal account you can send and request money from friends and family and pay online for purchases. Holders of certain existing personal accounts may be required to upgrade their accounts (which may include providing further information to PayPal) to be able to use all of the current functionality available in a personal account. To use your PayPal account primarily to sell things, you must open a business account or convert your personal account to a business account. Safe use of your PayPal account You should take reasonable steps to stop your PayPal account being misused. You must maintain adequate security and control of any and all devices, items, IDs, passwords and personal identification numbers / codes that you use to access your PayPal account and the PayPal services. You must comply with all reasonable instructions we may issue regarding how you can keep your Payment Instrument safe. We may require you to authenticate any instruction relating to your account (i.e. give us the information that we need to be sure that it’s you giving us the instruction, such as submitting your correct log-in information – this could include your e-mail address and password) and otherwise successfully log into your PayPal account to provide to us your instruction. You must keep your postal address, email address, phone number of a phone to which you are the primary user and other contact information current in your PayPal account profile. You may expressly grant, remove and manage permissions for some third parties to take certain actions on your behalf. In some cases you can do this when logged into your account – in other cases you can do this directly with the third party. You acknowledge that if you grant permission for a third party to take actions on your behalf, we may disclose certain information about your Account to this third party. You may permit third party service providers licensed by applicable law to: • provide account information services to access information about your account on your behalf; • confirm whether an amount necessary for the execution of a card-based payment transaction is available on your account; or • provide payment initiation services to initiate payments from your account on your behalf. Granting permission to any third party to access your account in any way does not relieve you of any of your responsibilities under this user agreement. You are liable to us for the actions that you authorise the third parties to carry out. You will not hold us responsible for, and you will indemnify us from, any liability arising from the actions or inactions of such third parties in connection with the permissions you granted, subject to your mandatory legal rights.

  • Accounts Excluded from Financial Accounts The following accounts are excluded from the definition of Financial Accounts and therefore shall not be treated as U.S. Reportable Accounts.

  • Checking Accounts The Credit Union may refuse any check or other item drawn against your account or used to withdraw funds from your account if it is not on a form approved by us. We also reserve the right to refuse any check or other item drawn against your account or used to withdraw funds from your account if made in a manner not specifically authorized for your account, if made more frequently or in a greater number than specifically permitted for your account, or if made in an amount less than the minimum withdrawal or transfer specifically permitted for your account. If we accept a check or other item not on a form approved by us, you will be responsible for any loss by us in handling the item. We may pay checks or other items drawn upon your account in any order determined by us, even if paying a particular check or item results in an insufficient balance in your account to pay one or more other items that otherwise could have been paid out of your account. Because of the nature of the Credit Union check program, neither the Credit Union nor any other processing entities shall be responsible for the authenticity of the checks with regard to the signature or alterations; and checks, when presented, shall be paid without verification. We may disregard all information on or any writing or memorandum attached to any check or item except for your signature, the amount and the information that is magnetically encoded. You agree that we do not fail to use ordinary care because our procedures do not provide for sight examination. You will notify us immediately if you learn or have reason to know that any of your checks have been lost or stolen. If you are negligent in safeguarding your checks or if there is a processing problem due to your use of a check printer we do not approve, we will not have any liability or responsibility for any losses you incur as a result if we act in good faith pursuant to standard commercial practices.

  • ISLAMIC ACCOUNTS 25.1 In the event that Customer, due to its observance of Islamic religious beliefs cannot receive or pay interest, Customer may elect to designate, in the manner provided by AvaTrade, its trading account to be an Islamic Account, which is not charged with, or entitled to, overnight interest and/or rollovers.

  • Deposit Accounts Neither Borrower nor any Subsidiary shall maintain any Deposit Accounts, or accounts holding Investment Property, except with respect to which Lender has an Account Control Agreement.

  • Business Accounts If you are a business, any authorized user of your business is authorized on such terms, conditions, and agreements as we may require to: • enter into this Agreement, as amended from time to time; • access each account of yours in any manner and for any purpose available through the Service, whether now available or available at some time in the future; and • use any Online banking service in any manner and for any purpose available through the Service, whether now available or available at some time in the future.

  • Other New Entity Accounts With respect to New Entity Accounts not described in paragraph A of this section, the Reporting Finnish Financial Institution must determine whether the Account Holder is: (i) a Specified U.S. Person; (ii) a Finnish Financial Institution or other Partner Jurisdiction Financial Institution; (iii) a participating FFI, a deemed-compliant FFI, or an exempt beneficial owner, as those terms are defined in relevant U.S. Treasury Regulations; or (iv) an Active NFFE or Passive NFFE.

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