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[DOC File]FORM AA 1
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Signature of Witness _____ A Barrister at law entitled to practise in Manitoba. or a Notary Public, or a Commissioner for Oaths, in and for the Province of Manitoba. My commission expires_____ Copy 1 ( Court of Queen's Bench (Family Division) Copy 2 - Adoption File. Copy 3 - Guardian. Copy 4 - Director. All four copies must be signed and witnessed. Adoption Form AA10 - Page 2 File No ...
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[DOCX File]FSAA Form
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Signature. Date. Office of Inspector General Receipt. Receiver. Phone. Title. Email. Signature. Date . For questions regarding the evaluation of a state program or if it has been determined that the state program is a state project and has not been assigned a CSFA number, contact your FSAA state agency liaison or the Department of Financial Services, Bureau of Auditing, at FSAA@MyFloridaCFO ...
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[DOC File]E-Form 857 (1997/09)
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Signature of obligant. Title: E-Form 857 (1997/09) Author: dfoti Last modified by: RBC Created Date: 7/7/2008 9:53:00 PM Company: XBS Other titles: E-Form 857 (1997/09) ...
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[DOCX File]Sabbatical Leave Application Form
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Date Signature of Applicant. The granting of the Sabbatical Leave to this applicant for the period(s) noted on this application (will) (will not) disrupt the continued and regular course offerings or affect the quality level of education offered to the students enrolled in this department/program, provided that the number of full-time faculty or librarian employees on leave from this ...
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[DOC File]SCI Request Form
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BUREAU CHIEF/AA/OFFICE DIRECTOR: Enter the name and electronic signature of the Bureau Chief, AA or Office Director. PHONE NUMBER: Enter the phone number of the Bureau Chief, AA or Office Director. DATE: Enter the date the Bureau Chief, AA or Office Director is signing the request. AMS Officer should email completed request form to SEC-SCIRequests@usaid.gov . SECTION 2: SECURITY …
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[DOCX File]Fax - AA-Clozapine Portal
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AA-CLOZAPINE Patient Care Network | 1165 Creditstone Rd., Unit 1, Vaughan, Ontario, L4K 4N7 | Tel: 1-877-276-2569 | Fax: 1-866-836-6778 TRAVEL WAIVER RECIPIENT INFORMATION
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[DOCX File]SJIYFA JUNIOR HIGH PLAYER’S AGREEMENT
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Player’s Signature. Print Name. PARENT’S CONSENT. I, the undersigned, do hereby certify that I am the parent or legal guardian of the Player who has signed the above (the “Player”), and hereby consent to the Player’s participation in the Association’s football program and approve the Player’s entering into the foregoing Player’s Agreement. I acknowledge the contagious nature of ...
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[DOC File]FORM AA 1
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Signature of Witness _____ A Barrister at law entitled to practise in Manitoba, or a Notary Public, or a Commissioner for Oaths, in and for the Province of Manitoba. My Commission expires _____ Copy 1 - Court of Queen's Bench (Family Division) Copy 2 - Applicant's Agency. Copy 3 - Guardian Agency. Copy 4 - Child. All four copies must be signed and witnessed. Adoption Form AA11 - Page 2 File No ...
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HIPAA PERMITS DISCLOSURE OF POLST TO OTHER HEALTHCARE ...
My signature below indicates that I or my designee have discussed with the patient or patient’s representative the patient’s goals and treatment options available to the patient based on the patient’s health. My signature below indicates to the best of my knowledge that these orders are consistent with the patient’s current medical condition and preferences. Signature of Treating ...
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Aa forms for signature