TO BE COMPLETED. BY THE PURCHASER
TO BE COMPLETED. BY BORROWER (if additional space is needed, attach additional sheets) Planned Income Next 12 Months Name Age Wages Other Name and address of employer or source of income 1. 2. 3.
TO BE COMPLETED. 3.2 The employee agrees to work at any other site that the Employer may deem to be applicable to complete the work.
TO BE COMPLETED. A theorem of Xxxx [Wikipedia] says that a completely simple semigroup S is iso- morphic to a Xxxx matrix semigroup Reem(G) where G is a group. If both directions of the isomorphism are efficient (are they?), then the wedge problem in S is reducible to the wedge problem in a group G, which should be equivalent to inversion in the group.
TO BE COMPLETED. BY BORROWER (If additional space is needed, attach additional sheets)
TO BE COMPLETED by the student and given to the instructor at the time an Incomplete grade is requested. Name: Date: ID: Email: Phone: Address: Course Number: Title: Instructor: CRN: Term: Year:
TO BE COMPLETED. BY PURCHASER IF (3) ABOVE IS CHECKED ---------------------------------------------------- The undersigned represents and warrants that it is purchasing this Security for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ___________________ ____________________________________ NOTICE: To be executed by an executive officer [TO BE ATTACHED TO GLOBAL SECURITIES] SCHEDULE OF INCREASES OR DECREASES IN GLOBAL SECURITY The following increases or decreases in this Global Security have been made: Date of Amount of decrease Amount of increase Principal amount Signature of Exchange in Principal in Principal amount of this Global authorized officer amount of this of this Global Security following of Trustee or Global Security Security such decrease or Securities Increase Custodian EXHIBIT A FORM OF FACE OF EXCHANGE SECURITY OR PRIVATE EXCHANGE SECURITY*/** CUSIP No. 50540R AD 0 XXXX Xx. XX00000XXX00 No. ___________________ $ ________________ Laboratory Corporation of America Holdings, a Delaware corporation, promises to pay to CEDE & CO., or registered assigns, the principal sum of [ ] Dollars on February 1, 2013.
TO BE COMPLETED. BY STUDENT University of Dayton (home school) and (host school) Consortium Term: ⭘ Fall ⭘ Spring ⭘ Summer Host Student ID Number (if known): Statement of Authorization: I agree to: I understand that: • Submit this form to the University of Dayton and to my • No funds will be sent to my Host School until this form Host School for completion. has been completed by me, the Host School, and the • Inform the University of Dayton immediately if I choose University of Dayton. not to enroll or otherwise cancel my participation in this • Any balance currently owed to the University of Dayton program. must be satisfied prior to any financial aid funds being • Allow the University of Dayton and my Host School to released to my Host School. share information relating to my enrollment and financial • I am responsible for any payment due to my Host aid eligibility. School prior to the start of classes as my funds cannot, • Maintain satisfactory academic progress. under any circumstance, be released prior to the date my classes begin. Student Signature: Date: I have attached a copy of my schedule from the host institution. I have attached my Undergraduate Transfer Credit Pre-Authorization (academic advisor/ Xxxx’x Office approval for transfer hours).
TO BE COMPLETED. BY SCHOOL This agreement was received by the school on and a copy of the agreement was provided to the parent/student.
TO BE COMPLETED by residents of a jurisdiction other than ther United States who are not “U.S. Persons”. Notwithstanding anything contained in Section 2.2, by initializing _____ this line the Subscriber represents, warrants and acknowledges that:
