Claim Information. Each Party shall promptly:
Claim Information. 6.2.1 Claimant is responsible for providing sufficient information to substantiate Customer's rights to remedies under this Exhibit C. Boeing may reject a claim for lack of sufficient information. At a minimum, such information must include:
Claim Information. Disclose all lawsuits, arbitrations and claims filed or raised by or against the Proposer over the last five (5) years, specifically identifying: • The project involved. • The parties involved. • The nature of the claim(s). • Amount at issue. • Disposition or status. • Litigation, case style, number, and jurisdiction.
Claim Information. If you need additional space to complete this form, please attached additional pages, and clearly identify by question number which question(s) you are answering on your attached pages.
Claim Information. If you need additional space to complete this form, please attached additional pages, and clearly identify by ques- tion number which question(s) you are answering on your attached pages.
Claim Information. As per clause H7.4, in respect of each ARRC Claim you submit under this Agreement, you must provide the NHI number of each Service User who was registered with your Pharmacy as receiving ARRC Pharmacy Services. From an indicative date of 1 February 2013 (subject to amendment after applying the Transitional Change Mechanism provisions in clause L7), you must also provide the DoB of each Service User in respect of all claims covered in clause H7.
Claim Information. Check the injury Claimant is claiming from Claimant’s use of DCOCs and indicate the date(s) of occurrence: Injury Type Date Surgery to remove gallbladder
Claim Information. The Settlement covers and provides money for all non-exempt crew members at Pacific Bells at any time during the Settlement Class Period and who did not opt out of the settlement (“Settlement Class Members”). You must complete the information below to receive a payment. Name: Address:
Claim Information. ProCare may supply prescription Claim information to external parties for the purposes of rebating, clinical Services, or other such Services as contracted by ProCare. In all cases, any information considered as trade secret shall remain confidential as outlined above.
Claim Information. For a protective claim for refund to be properly filed and considered, the claim or expense forming the basis of the potential 2053 deduction must be clearly identified. Using the check boxes provided, indicate whether you are filing the initial claim for refund, a claim for partial refund or a final claim. On the chart in Part 2, give the Form 706 schedule and item number of the claim or expense. List any amounts claimed under exceptions for ascertainable amounts (Regulations section 20.2053-1(d)(4)), claims and counterclaims in related matters (Regulations section 20.2053-4(b)), or claims under $500,000 (Regulations section 20.2053-4(c)). Provide all relevant information as described including, most importantly, an explanation of the reasons and contingencies delaying the actual payment to be made in satisfaction of the claim or expense. Complete columns E and F only if filing a notice of partial or final resolution. Show the amount of ancillary or related expenses to be included in the claim for refund and indicate whether this amount is estimated, agreed upon, or has been paid. Also show the amount being claimed for refund.
