Reimbursement Claim Form definition

Reimbursement Claim Form means the form as prescribed by the Government from time to time to be completed and submitted by the Principal Applicant and the Institution for claiming reimbursement under this Agreement;
Sample 1Sample 2Sample 3
Reimbursement Claim Form means the form as prescribed by the Government from time to time to be completed and submitted by the Fellowship Applicant and the Institution for claiming reimbursement under this Agreement; “relative” means the spouse, parent, child, brother or sister of the relevant person, and, in deducing such a relationship, an adopted child shall be deemed to be a child both of the natural parent and the adopting parent and a stepchild to be a child of both the natural parent and the stepparent;
Sample 1Sample 2Sample 3
Reimbursement Claim Form means the Court-approved claim form that must be timely completed and submitted for a Settlement Class Member to be eligible for reimbursement for Qualified Past Repair(s) as set forth in Section 9.A of this Agreement. A copy of the Reimbursement Claim Form that Class Members can download will be available on the settlement website, and there will also be an electronic version of the Reimbursement Claim Form that can be completed online and that allows for uploading of any required documentation to support a Claim. Together with the Settlement Administrator, the Settling Parties will cooperate to develop a proposed plain-English and user-friendly Reimbursement Claim Form to submit to the Court for its approval with the motion for preliminary approval.
Sample 1Sample 2Sample 3

Examples of Reimbursement Claim Form in a sentence

  • Reimbursement shall be made only when (1) written approval by completing the Personal Property Reimbursement Claim Form (Appendix H – also can be found on the CCCOE Website) for use of the personal property was given before the property was brought to the work site, and (2) the value of the property was agreed upon by the person or persons bringing the property and the program administrator at the time the approval for its use was given.

  • In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Member must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to HPN or its designee.

  • Reimbursement shall be made only when (1) written approval by completing the Personal Property Reimbursement Claim Form (Appendix H -also can be found on the CCCOE Website) for use of the personal property was given before the property was brought to the work site, and (2) the value of the property was agreed upon by the person or persons bringing the property and the program administrator at the time the approval for its use was given.

  • In order for claims for Covered Drugs obtained at a Non-Plan Pharmacy to be eligible for benefit payment, the Insured must complete and submit a Pharmacy Reimbursement Claim Form with the prescription label and register receipt to SHL or its designee.

  • Questions about HPN’s PDL should be directed to the Member Services Department at 000-000-0000 or the PDL and the Pharmacy Reimbursement Claim Form is available is available at xxxx://xxxxxxxxxxxxxxxxxx.xxx/~/media/Files/HPN/pdf/Forms/OptumRx- Reimbursement.ashx?la=en.

  • Questions about SHL’s PDL should be directed to the Member Services Department at 000-000-0000 or the PDL and the Pharmacy Reimbursement Claim Form is available at xxxxx://xxxxxxxxxxxxxxxxxxx.xxx/~/media/Files/SHL/pdf/Forms/Pharmacy-Reimbursement- Claim-Form.ashx?la=en.

  • The Long Form Notice and settlement website shall include the Frame Replacement Reimbursement Claim Form, which shall be in a form substantially similar to the document attached to this Settlement Agreement as Exhibit 1 and which shall inform the Class Member that he or she must fully complete and timely return the Frame Replacement Reimbursement Claim Form within the Claim Period to be eligible to obtain relief pursuant to this Settlement Agreement.

  • Persons or entities who believe that they are Class Members may contact Class Counsel or the Settlement Notice Administrator or complete and file a Frame Replacement Reimbursement Claim Form and provide necessary documentation indicating that they wish to be eligible for the relief provided in this Settlement Agreement.

  • All other expenses are to be submitted on a Travel Expense Reimbursement Claim Form.

  • For a Qualified Past Repair that occurred prior to the Notice Date, a Reimbursement Claim Form must be submitted to the Settlement Administrator postmarked or submitted electronically within sixty (60) days of the Notice Date.


More Definitions of Reimbursement Claim Form

Reimbursement Claim Form means the document, substantially in the form of Exhibit “D”.
Sample 1Sample 2Sample 3
Reimbursement Claim Form means the Court-approved claim form that must be timely completed and submitted for a Settlement Class Member to be eligible for reimbursement for Qualified Past Repair(s), as set forth in Section 9.A of this Agreement. A copy of the Reimbursement Claim Form will be available on and can be submitted via the settlement website. Together with the Settlement Administrator, the Settling Parties will cooperate to develop a proposed plain-English and user-friendly Reimbursement Claim Form to submit to the Court for its approval with the motion for preliminary approval.
Sample 1Sample 2
Reimbursement Claim Form means the form to be submitted by the Eligible Applicant, together with all documentation required to be submitted pursuant to that form and this Agreement, to request payment for Eligible Expenses,
Sample 1
Reimbursement Claim Form means the Court-approved claim form that must be timely completed and submitted for a Settlement Class Member to be eligible for reimbursement for Qualified Past Repair(s), as set forth in Section9.A of this Agreement. A copy of the Reimbursement Claim Form will be available on and can be submitted via the settlement website. Together with the Settlement Administrator, the Settling Parties will cooperate to develop a proposed plain-English and user-friendly Reimbursement Claim Form to submit to the Court for its approval with the motion for preliminary approval.
Sample 1

Related to Reimbursement Claim Form

  • Claim Form or “Proof of Claim Form” means the form, substantially in the form attached hereto as Exhibit 2 to Exhibit A, that a Claimant must complete and submit should that Claimant seek to share in a distribution of the Net Settlement Fund.

  • Reimbursement means that DOH will repay the Contractor for allowable costs incurred under the terms of this contract.

  • Reimbursement insurance policy means a policy of insurance

  • Indemnified Claim has the meaning set forth in Section 8.2.

  • Indemnification means an agreement of indemnity or a release from liability where the intent or effect is to shift or limit in any manner the potential liability of the person or firm for failure to adhere to applicable auditing or professional standards, whether or not resulting in part from knowing of other misrepresentations made by the insurer or its representatives.

  • Reimbursement Amount As defined in Section 2.04.

  • Infringement Claim means a third party claim alleging that the Equipment manufactured by Motorola or the Motorola Software directly infringes a United States patent or copyright.

  • Expected Claim Notice means a notice that, as a result of a legal proceeding instituted by or written claim made by a third party, an Indemnified Party reasonably expects to incur Damages for which it is entitled to indemnification under Article VI.

  • Professional Fee Claim means a Claim by a professional seeking an award by the Bankruptcy Court of compensation for services rendered or reimbursement of expenses incurred through and including the Confirmation Date under sections 330, 331, 503(b)(2), 503(b)(3), 503(b)(4), or 503(b)(5) of the Bankruptcy Code.

  • Contingent Claim means any Claim, the liability for which attaches or is dependent upon the occurrence or happening of, or is triggered by, an event, which event has not yet occurred, happened or been triggered as of the date on which such Claim is sought to be estimated or an objection to such Claim is filed, whether or not such event is within the actual or presumed contemplation of the holder of such Claim and whether or not a relationship between the holder of such Claim and FairPoint now or hereafter exists or previously existed.