Sign here Sample Clauses

Sign here. I declare that the information on this certificate is correct and complete to the best of my knowledge and belief. Signature of Authorized Purchaser Print Name Here Title Date Streamlined Sales and Use Tax Agreement Certificate of Exemption Multistate Supplemental Name of Purchaser: STATE Reason for Exemption Identification Number (If Required) AR* GA IA IN KS KY MI MN NC ND NE NJ NV OH OK RI SD TN* UT VT WA WI WV WY *SSUTA Direct Mail provisions are not in effect for Arkansas and Tennessee. The following nonmember states will accept this certificate for exemption claims that are valid in their respective state. SSUTA Direct Mail provisions do not apply in these states. XX XX XX
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Sign here. I declare that the information on this certificate is correct and complete to the best of my knowledge and belief. Signature of Authorized Purchaser Print Name Here Title Date 21999 (8/27/09) Streamlined Sales and Use Tax Agreement Certificate of Exemption Multi-state Supplemental Name of Purchaser STATE Reason for Exemption Identification Number (If Required) AR IA IN KS KY MI MN NC ND NE NJ NV OH OK RI SD TN UT VT WA WI WV WY SSUTA Direct Mail provisions are not in effect for Tennessee. The following nonmember states will accept this certificate for exemption claims that are valid in their respective state. SSUTA Direct Mail provisions do not apply in these states. SSTGB Form F0003 Exemption Certificate (8/27/09) Streamlined Sales and Use Tax Agreement - North Dakota Certificate of Exemption Instructions Use this form to claim exemption from sales tax on purchases of otherwise taxable items. The purchaser must complete all fields on the exemption certificate and provide the fully completed certificate to the seller in order to claim exemption.
Sign here. I declare that the information on this certificate is correct and complete to the best of my knowledge and belief. Signature of Authorized Purchaser Print Name Here Title Date
Sign here. The undersigned and any recipient of Common Stock or a new Warrant hereunder are “accredited investors” as defined in Regulation D promulgated under the Securities Act of 1933, as amended. (Signature of Warrant Holder or Authorized Signatory) Date (Type or Print Name of Warrant Holder or Authorized Signatory) NOTE: The above name and signature should correspond exactly with the name on the first page of this Warrant or with the name of the assignee appearing in the form of assignment attached as Annex B to the Warrant. Annex B to Common Stock Purchase Warrant
Sign here. SUBSCRIBER: ----------------------------------- --------------------------- Signature Date ----------------------------------- --------------------------- Printed Name ----------------------------------- Address ----------------------------------- City State Zip ------------------------- --------------------------- Social Security No. Number of Shares Subscribed For Purchase SPOUSE OF SUBSCRIBER: ----------------------------------- Signature ORGANIZATION(S) SIGN HERE: SUBSCRIBER: ----------------------------------- --------------------------- Print name of organization Date By -------------------------------- Title ----------------------------- ----------------------------------- Address ----------------------------------- City
Sign here. Although Rutgers Cooperative Extension and its event coordinator(s) will use the utmost precaution in guarding the health of all participants and preventing accidents, I release them from any liability in case of injury as a result of this activity. Furthermore, I release the owner and driver of the car transporting me to and from this event, from any liability in the case of illness or injury. Signature of adult participant
Sign here. I declare that the information on this certificate is correct and complete to the best of my knowledge and belief.
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Sign here. The undersigned and any recipient of Common Stock or a new Warrant hereunder are “accredited investors” as defined in Regulation D promulgated under the Securities Act of 1933, as amended. (Signature of Warrant Holder or Authorized Signatory) Date ___________________________________________________ (Type or Print Name of Warrant Holder or Authorized Signatory) NOTE: The above name and signature should correspond exactly with the name on the first page of this Warrant or with the name of the assignee appearing in the form of assignment attached as Annex B to the Warrant. Annex B to Common Stock Purchase Warrant FORM OF ASSIGNMENT (To be executed upon transfer of Common Stock Purchase Warrant) FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers to ____________________ the right represented by the within Warrant, as such right may apply to _________ shares of Common Stock which are the subject of the within Warrant, together with all rights, title and interest therein, and does hereby irrevocably constitute and appoint ____________________ attorney to transfer such Warrant on the warrant register of the within named Company, with full power of substitution. DATED: _________________. Signature: (Signature must conform in all respects to name of Holder as specified on the face of the Warrant)
Sign here. I declare that the information on this certificate is correct and complete to the best of my knowledge and belief. Signature of authorized purchaser Print name here Title Date Web-Fill 8-06 Streamlined Sales and Use Tax Agreement Certificate of Exemption: Multistate Supplemental Name of purchaser State Reason for exemption Identification number (if required) AR* IA IN KS KY MI MN NC ND NE NJ NV OH OK SD TN* UT WV WY *SSUTA Direct Mail and MPU provisions are not in effect for Arkansas and Tennessee. Streamlined Sales and Use Tax Agreement Certificate of Exemption Instructions Use this form to claim exemption from sales tax on purchases of taxable items. The purchaser must complete all fields on the exemption certificate and provide the fully completed certificate to the seller in order to claim exemption.
Sign here. Lockboxes will be picked up in Boca Raton and you will retrieve the lockbox from your location when you are done and return the lockbox to Prestigious Homes. There are no refunds on lockboxes that are not returned or are broken . Electronic lockboxes will be in working order and tested upon return. If needed, Prestigious Homes can pick up lockboxes for a fee this will at prestigious homes discretion. We xxxx Lock Boxes at the time of pick up, please do not add to your total amount the Lock Box Deposit to be charged (located in page 5)
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