Clear Form Sample Clauses

Clear Form. Privacy Act Statement Authority ─ This information is being collected under the authority of 5 U.S.C. § 4115, a provision of The Government Employees Training Act.
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Clear Form. For WAFWA Use ☐ Mitigated Project, or ☐ Credit Generating Ecoregion: FACZ ID: CCAA Participant Company: Project Name/Identifier: Project Location: Use of early and effective remediation techniques to return developed lands with inactive impacts back to pre-impact conditions can help to reduce habitat loss and fragmentation of the southern Great Plains. To demonstrate that impacts were remediated, the CCAA Participant must provide WAFWA with documentation demonstrating that the remediation activities have occurred and that the remediated area has been seeded with native vegetation, at least to the minimum standard defined by the Natural Resources Conservation Service’s Conservation Practice Code 550 (Range Planting). WCA / CCAA Appendix B - Process for Generating Units from Remediation. REMEDIATED PROJECT Brief description of the reclaimed project, including the construction date: Example: Compressor station on 4.25 acres with access road from CR 205, constructed in 2013. Was this project mitigated/enrolled under the ☐ WCA or ☐ CCAA?
Clear Form. Instructions Agencies must complete a separate worksheet for each transaction type, i.e., one for a sale and one for a purchase, when an employee: • Has an approved authorization to transfer from an old to a new official station. • Has incurred expenses for the sale of a residence at the employee’s old official station, and/or the purchase of a residence at the new official station. PURPOSE OF THIS WORKSHEET This worksheet assists agencies in determining reimbursable expenses associated with a residential sale versus purchase by use of: • Shaded fields which show that an expense is not allowable for the type of residential expenses incurred, e.g., An application fee is not reimbursable for a residential sale. • “Reference” or “Summary” fields which note the federal regulations or other authorities under which an expense is determined to be reimbursable or not: Code of Federal Regulations (CFR), General Service Administration Board of Contract Appeals (GSCBA), or Civilian Board of Contract Appeals (CBCA). • Auto‐populated fields which calculate amounts. COMPLETING THIS WORKSHEET EMPLOYEE INFORMATION Enter the following information: • Employee’s Name • Authorization Number • Date Service Agreement SignedEmployee Name on Title or Equitable Title Interest: Select whether the employee’s name is on the title, or if the employee holds equitable title interest. o Name on Title ‐ may be solely in the employee’s name, in the name of one or more immediate family members, or jointly in all names. o Hold Equitable Title Interest – Generally, this is associated with a person’s financial interest in a residence with family or non‐family members. The most common example is property transferred to beneficiaries through a trust. In this situation, the employee may only claim a pro rata share of the reimbursement. Refer to 41 CFR 302‐11.105 for supporting documentation requirements. o Percent: Enter the employee’s pro rata share, e.g., .05 for 5%. Usually, the employee’s share is written in the trust instructions or prorated based on the number of people also holding equitable title interest. RESIDENTIAL TRANSACTION INFORMATION Enter the following information: • Type of Residential Transaction: Sale or Purchase • Residential Sale Price (Sale ONLY) • Residential Purchase Price and Loan Amount Purchase ONLY) • Reporting Date • Extension Granted and Date: Select Yes or No. If Yes, enter the extension date. Please note the following: o Relocation authorizations are active for...
Clear Form. Check For Updates PAGE 1 OF 2 WORKING WITH A REALTOR® (DESIGNATED AGENCY)

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  • Escrow Instructions Upon execution of this Agreement, the parties hereto shall deposit an executed counterpart of this Agreement with the Title Company, and this instrument shall serve as the instructions to the Title Company as the escrow holder for consummation of the purchase and sale contemplated hereby. Seller and Buyer agree to execute such reasonable additional and supplementary escrow instructions as may be appropriate to enable the Title Company to comply with the terms of this Agreement; provided, however, that in the event of any conflict between the provisions of this Agreement and any supplementary escrow instructions, the terms of this Agreement shall control.

  • Resume Self-Certification Form When submitting a response to an RFQ the Contractor shall submit with its response a completed and signed Resume Self-Certification Form (Contract Exhibit F) to the Customer for each proposed Staff member identified in the RFQ response.

  • Instructions for Certification – First Tier Participants a. By signing and submitting this proposal, the prospective first tier participant is providing the certification set out below.

  • CONTRACT FORM Observe the Contract and confirm the form number on the Contract is on the List of Approved Contract Forms.

  • Exhibit C Litigating Subdivisions List12

  • Form Certificated ADSs shall be evidenced by definitive ADRs which shall be engraved, printed, lithographed or produced in such other manner as may be agreed upon by the Company and the Depositary. ADRs may be issued under the Deposit Agreement in denominations of any whole number of ADSs. The ADRs shall be substantially in the form set forth in Exhibit A to the Deposit Agreement, with any appropriate insertions, modifications and omissions, in each case as otherwise contemplated in the Deposit Agreement or required by law. ADRs shall be (i) dated, (ii) signed by the manual or facsimile signature of a duly authorized signatory of the Depositary, (iii) countersigned by the manual or facsimile signature of a duly authorized signatory of the Registrar, and (iv) registered in the books maintained by the Registrar for the registration of issuances and transfers of ADSs. No ADR and no Certificated ADS evidenced thereby shall be entitled to any benefits under the Deposit Agreement or be valid or enforceable for any purpose against the Depositary or the Company, unless such ADR shall have been so dated, signed, countersigned and registered. ADRs bearing the facsimile signature of a duly-authorized signatory of the Depositary or the Registrar, who at the time of signature was a duly-authorized signatory of the Depositary or the Registrar, as the case may be, shall bind the Depositary, notwithstanding the fact that such signatory has ceased to be so authorized prior to the Delivery of such ADR by the Depositary. The ADRs shall bear a CUSIP number that is different from any CUSIP number that was, is or may be assigned to any depositary receipts previously or subsequently issued pursuant to any other arrangement between the Depositary (or any other depositary) and the Company and which are not ADRs outstanding hereunder.

  • Exhibit A The Collateral consists of all of Borrower’s right, title and interest in and to the following: All goods, equipment, inventory, contract rights or rights to payment of money, leases, license agreements, franchise agreements, general intangibles (including payment intangibles), accounts (including health-care receivables), documents, instruments (including any promissory notes), chattel paper (whether tangible or electronic), cash, deposit accounts, fixtures, letters of credit rights (whether or not the letter of credit is evidenced by a writing), commercial tort claims, securities, and all other investment property, supporting obligations, and financial assets, whether now owned or hereafter acquired, wherever located; and All Borrower’s books relating to the foregoing and any and all claims, rights and interests in any of the above and all substitutions for, additions, attachments, accessories, accessions and improvements to and replacements, products, proceeds and insurance proceeds of any or all of the foregoing. Notwithstanding the foregoing, the Collateral shall not be deemed to include any copyrights (including computer programs, blueprints and drawings), copyright applications, copyright registration and like protection in each work of authorship and derivative work thereof, whether published or unpublished, now owned or hereafter acquired; any design rights; any patents, patent applications and like protections including without limitation improvements, divisions, continuations, renewals, reissues, extensions and continuations-in-part of the same, trademarks, servicemarks and applications therefor, whether registered or not; or any Intellectual Property, except that the Collateral shall include all accounts, license and royalty fees and other revenues, proceeds, or income arising out of or relating to any of the foregoing. Pursuant to the terms of a certain negative pledge arrangement with Bank, Borrower has agreed not to encumber any of its Intellectual Property without Bank’s prior written consent. EXHIBIT B SPECIALTY FINANCE DIVISION Compliance Certificate I, an authorized officer of TINTRI, INC. (“Borrower”) certify under the Loan and Security Agreement (as amended, the “Agreement”) between Borrower and Silicon Valley Bank (“Bank”) as follows for the period ending (all capitalized terms used herein shall have the meaning set forth in this Agreement): Borrower represents and warrants for each Financed Receivable: Each Financed Receivable is an Eligible Account; Borrower is the owner with legal right to sell, transfer, assign and encumber such Financed Receivable; The correct amount is on the Invoice Transmittal and is not disputed; Payment is not contingent on any obligation or contract and Borrower has fulfilled all its obligations as of the Invoice Transmittal date; Each Financed Receivable is based on an actual sale and delivery of goods and/or services rendered, is due to Borrower, is not past due or in default, has not been previously sold, assigned, transferred, or pledged and is free of any liens, security interests and encumbrances other than Permitted Liens; There are no defenses, offsets, counterclaims or agreements for which the Account Debtor may claim any deduction or discount; Borrower reasonably believes no Account Debtor is insolvent or subject to any Insolvency Proceedings; Borrower has not filed or had filed against it Insolvency Proceedings and does not anticipate any filing; Bank has the right to endorse and/ or require Borrower to endorse all payments received on Financed Receivables and all proceeds of Collateral. No representation, warranty or other statement of Borrower in any certificate or written statement given to Bank contains any untrue statement of a material fact or omits to state a material fact necessary to make the statement contained in the certificates or statement not misleading.

  • Instructions for Certification 1. By signing and submitting this CONTRACT, the prospective lower tier participant is providing the certification set out below.

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