APGFCU® Cash Back Credit Card Disclosure Statement and AgreementStatement and Agreement • October 21st, 2019 • Maryland
In this Agreement the words “you” and “your” mean each and all of those who apply for the card or use the card. “Card” means the Cash Back Visa® Credit Card and any duplicates and renewals we issue. “Account” means your APGFCU Cash Back Visa Credit Card Line of Credit account with us. “We,” “us” and “ours” means Aberdeen Proving Ground Federal Credit Union (APGFCU). By signing, using or accepting the APGFCU Cash Back Visa Credit Card, you acknowledge receipt of this Agreement and agree to terms herein.
Consumer eBanking Disclosure Statement and AgreementStatement and Agreement • August 8th, 2022
PART A – General AgreementStatement and Agreement • October 8th, 2020 • Florida
This eBanking Disclosure Statement and Agreement (the “Agreement”) identifies the terms and conditions that govern the use of United Bank’s eBanking, Mobile Banking, Bill Payment, Mobile Deposit Service and Zelle Transfer Service (the “Service”). You agree that the use of the Service is subject to the Terms and Conditions of Your Account and any other applicable agreements you have with us. In the event of a conflict between agreements, this Agreement will control the use of the Service. Any disputes arising from the use of this Service or this Agreement will be handled in accordance with the Terms and Conditions of Your Account. We reserve the right to modify, add, or remove portions of the Service at any time. This Agreement is subject to change at any time. We will notify you of any material change in these terms via e-mail, our bank web-site (www.bankwithunited.com) and/or our mobile banking web- site (http://m.bankwithunited.com). Your continued use of the Service will be
Disclosure Statement and Agreement for ServicesStatement and Agreement • November 13th, 2020
This document is intended to provide important information to you regarding your treatment. Please read the entire document carefully and be sure to ask your therapist any questions that you may have regarding its contents.
City of SomersworthStatement and Agreement • February 23rd, 2023
Statement and Agreement betweenStatement and Agreement • September 14th, 2012
AES Gener SA, hereinafter referred to as Gener, is developing the Alto Maipo Hydroelectric Project (the Project or PHAM), which contemplates the construction of two hydroelectric plants, called Alfalfal II and Las Lajas which, together, will have a maximum power of 531 MW. The Project is located south of the city of Santiago, and uses the waters of the Colorado River, among others.
Statement and Agreement Regarding PeaceHealth InformationStatement and Agreement • November 20th, 2006
During the course of your work with PeaceHealth, you may develop, use, maintain, or have incidental contact with or access to patient information or business information that is confidential (“PeaceHealth Information”). PeaceHealth Information from any source in any form (including paper records, oral communication, audio recordings, and electronic displays) should be kept strictly confidential. You may access PeaceHealth Information only if you need to know the specific PeaceHealth Information to perform your job responsibilities.
DATA PRIVACY STATEMENT AND AGREEMENTStatement and Agreement • April 25th, 2022
The College of Social Sciences and Philosophy (CSSP) and all its subsidiary offices and departments recognize their responsibilities under the Republic Act No. 10173, also known as the Data Privacy Act of 2012, with respect to the data they collect, record, organize, update, use, consolidate, disclose, transfer and subsequently dispose from their clients. The personal data obtained from all transactions are entered and stored within the Unit’s authorized information and communications system and will only be accessed by authorized CSSP personnel. The CSSP has instituted appropriate organizational, technical and physical security measures to ensure the protection of the client’s personal data.
STATEMENT AND AGREEMENT OF CONFIDENTIALITYStatement and Agreement • July 1st, 2016
Bill Pay Disclosure Statement and AgreementStatement and Agreement • May 27th, 2022
This agreement states the terms and conditions that apply when you use our bill pay service through online, software, or other methods that we may provide. These terms and conditions are in addition to those that apply to any accounts you have with us or any other services you obtain from us. You must follow all of our instructions and procedures applicable to the services covered by this agreement.
Financial Policy Statement and AgreementStatement and Agreement • March 8th, 2009
We are committed to providing you with the best possible care. If you have medical insurance, we are anxious to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance, and your understanding of our payment policy.
ContractStatement and Agreement • February 2nd, 2022 • New York
Electronic Funds Transfer Disclosure Statement and Agreement (for ESL ATM Card, ESL Visa® Debit Card, ESL Visa® Health Savings Account Card, TEL-E$L®, Automated Clearing House (ACH) Transactions, Electronic Check Conversion (ECK), ESL Online Banking, ESL Mobile Banking and ESL Online Bill Pay)
TIS Candidate Assurance Statement and Agreement (DUE 4/26/2019)Statement and Agreement • March 22nd, 2019
If I am selected to participate in the 19-20 Technology Integration Specialists Cohort, I hereby give my assurances that I will:
Statement and Agreement Regarding PeaceHealth InformationStatement and Agreement • July 8th, 2008
During the course of your work with PeaceHealth, you may develop, use, maintain, or have incidental contact with or access to patient information, employee information and/or business information that is confidential (“PeaceHealth Information”). PeaceHealth Information from any source in any form (including paper records, oral communication, audio recordings, and electronic displays) shall be kept strictly confidential. You may access PeaceHealth Information only if you need to know the specific PeaceHealth Information to perform your job responsibilities.
RECITALSStatement and Agreement • July 20th, 2017 • Florida
WHEREAS, Saltzman, Tanis, Pittell, Levin & Jacobson, Inc. d/b/a Pediatric Associates and its affiliated entities, Pediatric Associates of Tampa Bay, LLC, and Pediatric Associates of Northeast Florida, LLC (hereafter “Sponsor”) have contractual relationships with health care plans (“HCPS”);
Statement and Agreement Regarding PeaceHealth InformationStatement and Agreement • July 26th, 2011
During the course of your work/services with PeaceHealth and/or its affiliated entities, you may develop, use, maintain, or have incidental contact with or access to patient information, employee information and/or business information that is confidential (“PeaceHealth Information”). PeaceHealth Information from any source in any form (including paper records, oral communication, audio recordings, and electronic displays) shall be kept strictly confidential. You may access PeaceHealth Information only if you need to know the specific PeaceHealth Information to perform your responsibilities.
STATEMENT AND AGREEMENT PERTAINING TO LOSS OR DESTRUCTION OF POLICYStatement and Agreement • February 2nd, 2023
Because of the loss or destruction of my policy I hereby request that HOMESTEADERS LIFE COMPANY issue a duplicate copy of the policy, or a certification of coverage in lieu thereof, to be numbered the same as the original. In consideration of the granting of this request, I agree as follows:
Statement and Agreement Regarding PeaceHealth InformationStatement and Agreement • July 21st, 2008
During the course of your work with PeaceHealth, you may develop, use, maintain, or have incidental contact with or access to patient information, employee information and/or business information that is confidential (“PeaceHealth Information”). PeaceHealth Information from any source in any form (including paper records, oral communication, audio recordings, and electronic displays) shall be kept strictly confidential. You may access PeaceHealth Information only if you need to know the specific PeaceHealth Information to perform your job responsibilities.
Platinum Secured Visa® Disclosure Statement and AgreementStatement and Agreement • January 30th, 2020 • California
IMPORTANT: This Agreement contains full and complete disclosure of all rates and charges applicable to First U.S. Community Credit Union’s Platinum Secured Visa and the terms of the Agreement for use of the Platinum Secured Visa card.
VISA® Disclosure Statement and AgreementStatement and Agreement • September 14th, 2017
IMPORTANT: This Agreement contains full and complete disclosure of all rates and charges applicable to First U.S. Community Credit Union’s VISA® and the terms of the Agreement for use of the VISA® card.
Statement and Agreement Regarding PeaceHealth InformationStatement and Agreement • February 24th, 2012
During the course of your work/services with PeaceHealth and/or its affiliated entities, you may develop, use, maintain, or have incidental contact with or access to patient information, employee information and/or business information that is confidential (“PeaceHealth Information”). PeaceHealth Information from any source in any form (including paper records, oral communication, audio recordings, and electronic displays) shall be kept strictly confidential. You may access PeaceHealth Information only if you need to know the specific PeaceHealth Information to perform your responsibilities.
M3T Child Protection Statement and AgreementStatement and Agreement • March 10th, 2008
Confidentiality Agreement)Statement and Agreement • September 17th, 2013
During the course of your work/services with PeaceHealth and/or its affiliated entities, you may develop, use, maintain, or have incidental contact with or access to patient information, employee information and/or business information that is confidential (“PeaceHealth Information”). PeaceHealth Information from any source in any form (including paper records, oral communication, audio recordings, and electronic displays) shall be kept strictly confidential. You may access PeaceHealth Information only if you need to know the specific PeaceHealth Information to perform your responsibilities.
