SURNAME. 2.3 IDENTITY NUMBER
SURNAME. 1.8 Postcode
SURNAME. 2. First name
SURNAME. FIRST NAME: Initials: MIDDLE NAME(S): Date:
SURNAME. The signatories observe the following rules for the period of their cohabitation.
SURNAME. PESEL (Personal Identification Number) ID/RESIDENCE PERMIT CARD: ............................................................................................................................... NO EXPIRY DATE EXPIRY DATE PASSPORT: ................................................................................................................................................................. EXPIRY DATE REGISTERED RESIDENCE ADDRESS STREET/NUMBER ..........................................................................................................................................................
SURNAME. FULL NAMES: IDENTITY NUMBER (copy of ID to be attached as per FICA requirements): RESIDENTIAL ADDRESS: POSTAL ADDRESS: EMPLOYER: WORK ADDRESS: CONTACT DETAILS: (W): (H): (C): FAX NUMBER: E-MAIL ADDRESS: MARITAL STATUS: Unmarried DETAILS OF THE INTENDED WIFE: SURNAME: FULL NAMES: IDENTITY NUMBER (copy of ID to be attached as per FICA requirements): RESIDENTIAL ADDRESS: POSTAL ADDRESS: EMPLOYER: WORK ADDRESS: CONTACT DETAILS: (W): (H): (C): FAX NUMBER: E-MAIL ADDRESS: MARITAL STATUS: Unmarried herein after jointly referred to as ‘the client’ DETAILS OF THE INTENDED MARRIAGE: DATE: CEREMONY TIME: RECEPTION TIME: PLACE OF CEREMONY: PLACE OF RECEPTION: CLIENT’S BANKING DETAILS FOR REFUNDABLE DEPOSIT: NAME: BANK: BRANCH: BRANCH CODE: ACCOUNT NO: We hereby agree to the services provided for by HEA on the following terms and conditions and accept that the following terms and conditions are legally binding whether signed by us or not if we have received same. WHEREBY IT IS AGREED AS FOLLOWS:
SURNAME. I have read and agree to the terms and conditions. I am authorised to submit this application on behalf of this product, operator, and/or related business entity. I have read the privacy statement. Please note that the Department of Resources, Energy and Tourism will notify your program manager(s) on your behalf that you have accepted the terms and conditions of this sub-licence. Signing page EXECUTED as an agreement. Signed for and on behalf of the Commonwealth of Australia as represented by the Department of Resources, Energy and Tourism by its duly authorised representative in the presence of Signature of witness Signature of representative Name of witness (print) Name of representative (print) Position of representative (print) [Select one of the following execution clauses. Where the successful applicant is a company, select the first execution block below, otherwise, select the second option.] Executed by [insert name of successful applicant] in accordance with section 127 of the Corporations Act 2001 Signature of director Signature of a second director/company secretary/sole director and sole company secretary (Please delete as applicable) Name of director (print) Name of a second director/company secretary/sole director and sole company secretary (print) Signed by [insert successful applicant name] in the presence of Signature of witness Signature of Program Manager
SURNAME. The Hirer agrees to comply with all terms of this agreement and fully understands that Waverunner (Jetski) hire is uninsurable for commercial use and any or all damage caused whilst in your possession will be your financial responsibility.
SURNAME. SIGNATURE OF AUTHORISED REPRESENTATIVE: DATE:
