INFORMATION ABOUT THE RECOVERY FUND PROCESS
|
|
|
- Sophie Wells
- 10 years ago
- Views:
Transcription
1 TEXAS DEPARTMENT OF SAVINGS & MORTGAGE LENDING Douglas B. Foster Commissioner INFORMATION ABOUT THE RECOVERY FUND PROCESS The Texas Department of Savings and Mortgage Lending accepts signed, written claims for reimbursement from the Recovery Fund for actual out of pocket damages sustained by borrowers caused by the acts of mortgage loan originators that violate specific provisions of Texas Finance Code Chapter 156, the Mortgage Broker License Act or MBLAct. Attached is a claim form. If you wish to file a claim against the Recovery Fund, please complete the entire form and sign the form before a notary public. PLEASE NOTE THAT THE CLAIM IS A SWORN FORM AND THAT A PERSON WHO KNOWINGLY MAKES A FALSE STATEMENT IN CONNECTION WITH APPLYING FOR REIMBURSEMENT FROM THE FUND MAY BE SUBJECT TO CRIMINAL PROSECUTION UNDER TEXAS PENAL CODE SECTION Upon receipt of the claim, the Department will notify the licensee of the claim and investigate the allegations giving rise to the claim. The Department will make a preliminary determination as to the validity of the claim, giving the claimant and the licensee the opportunity to resolve the matter by agreement or dispute the preliminary finding. If the matter is not resolved by the parties and the preliminary determination is not disputed by the 31 st day after the notification date, the preliminary determination will become final and the Commissioner shall make payment from the Recovery Fund to the claimant. If the preliminary determination is disputed by the claimant or the licensee, the matter shall be set for a hearing before the Administrative Law Judge in accordance with Texas Government Code Chapter Claims against the Recovery fund are limited to $25, per transaction. In the event there are multiple claimants against a license on the same transaction that exceed the payment limitations, the payments shall be prorated among the claimants based on the amount of damages suffered by each claimant. Following the payment of funds to a claimant from the Recovery Fund, the Commissioner shall be subrogated to all of the rights of the claimant to the extent of the amount paid. The failure of a claimant to comply with the provisions of the MBLAct or its associated rules pertaining to Recovery Fund claims shall constitute a waiver of any rights there under. The complete provisions concerning the Recovery Fund are in Texas Finance Code Subchapter F which may be linked from the home page.
2 (PLEASE PRINT OR TYPE WITH BLUE OR BLACK INK) Department Use Only Complaint Number: Department Use Only Date Received: Please mail all correspondence to: TEXAS SAVINGS AND MORTGAGE LENDING DEPARTMENT ATTN: ENFORCEMENT DIVISION 2601 NORTH LAMAR, SUITE 201 AUSTIN, TEXAS (FAX ) YOUR CONTACT INFORMATION: RECOVERY FUND APPLICATION Name: Address: City/State/Zip: Telephone Numbers: Work Home Cell Fax address: SSN: PLEASE PROVIDE THE FOLLOWING INFORMATION CONCERNING THE MORTGAGE BROKER, LOAN OFFICER OR MORTGAGE BANKER AGAINST WHOM YOU ARE FILING THIS APPLICATION: Person s Name: Company s Name: Physical Address: City/State/Zip: Telephone Number(s): License Number or Registration Number (if known):
3 PAGE 2 DATE(S) OF TRANSACTION: DO YOU HAVE AN ATTORNEY REPRESENTING YOU IN THIS MATTER? YES NO IF YES, PLEASE PROVIDE THE FOLLOWING INFORMATION: Attorney s Name: Attorney s Address: City/State/Zip: Telephone Number(s): PLEASE LIST THE NAMES, ADDRESSES, AND TELEPHONE NUMBERS OF ANY WITNESSES WHO HAVE OR MAY HAVE INFORMATION CONCERNING THE SUBJECT MATTER OF YOUR APPLICATION: CLAIM DETAIL: List the facts of your claim in the order of their occurrence, starting with the earliest date and working forward. Attach additional sheets as needed.
4 PAGE 3 PLEASE ITEMIZE THE AMOUNTS FOR WHICH YOU ARE SEEKING RECOVERY: HAVE YOU PREVIOUSLY NOTIFIED THE PERSON OR COMPANY NAMED ON PAGE ONE ABOUT YOUR CLAIM? YES NO HOW DID YOU NOTIFY THEM? WRITTEN ORAL WHAT WAS THE RESPONSE? SIGNATURE BLOCK I hereby state that I am not the spouse, child, parent, grandchild, grandparent or sibling, including by adoption, of the person against whom this application is filed. I further state that I am not sharing living quarters with the person against whom this application is filed, or any current or former employer, employee or associate of the person against whom this application is filed. I further affirm that I have not aided, abetted or participated, other than as a victim, with the person against whom this application is filed in any activity that is illegal under Texas Finance Code Sections (a)(2), (3), (5), (6), (8), (9), (10), (11), (12), (13) or (16) or under Section I further state that I am not seeking recovery or compensation as a licensed mortgage broker, loan officer or mortgage banker in the transaction or transactions for which this application is made. The information contained herein and all enclosed documents are true and correct to the best of my knowledge. I understand that I may be required to testify at a hearing and that a copy of my application will be made available to the person or company against whom it is filed. I understand that any false statement made herein may subject me to criminal prosecution under Texas Penal Code Section Signature of Applicant Signature of Applicant Date Date STATE OF TEXAS COUNTY OF BEFORE ME, the undersigned authority, on this day personally appeared and, known to me to be the person(s) whose name(s) is(are) subscribed to the foregoing document, and, being by me first duly sworn, declared under oath that the statements contained in the above and foregoing Recovery Fund Application are true and correct. Notary Public, State of Texas
5 PAGE 4 ADDITIONAL SHEET FOR APPLICATION DETAIL
LAWYERS FUND FOR CLIENT PROTECTION Established by the Maine Supreme Judicial Court P O Box 5084 Augusta, ME 04332-5084
LAWYERS FUND FOR CLIENT PROTECTION Established by the Maine Supreme Judicial Court P O Box 5084 Augusta, ME 04332-5084 Phone 207-623-7801 Fax 207-623-4175 CLAIM FORM FOR REIMBURSEMENT Information and Instructions
LAWYERS FUND FOR CLIENT COMPENSATION
LAWYERS FUND FOR CLIENT COMPENSATION CLAIM APPLICATION FORM INSTRUCTIONS: Complete each question on this form. Please print or type. If space is inadequate, attach additional pages. Also submit copies
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION DIVISION OF FINANCIAL INSTITUTIONS
RA 10 (DFI Page 1) STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION DIVISION OF FINANCIAL INSTITUTIONS APPLICATION FOR REGISTRATION OF A TITLE AGENT All information must be typewritten.
Grandparent s Power of Attorney Information and Forms
NOTICE AND DISCLAIMER Grandparent s Power of Attorney Information and Forms The forms in this packet have been provided to you as a public service by the Butler County Juvenile Court. Although you may
VICTIM COMPENSATION APPLICATION
OFFICE OF THE ATTORNEY GENERAL Crime Prevention & Victim Services Crime Victim Compensation Division Post Office Box 220 Jackson, Mississippi 39205-0220 1-800-829-6766 or 601-359-6766 601-576-4445 (FAX)
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION DIVISION OF BANKING
STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION DIVISION OF BANKING IN THE MATTER OF: ) ) MAGDALENA ESTEVES ) No. 2013-MLO-CD-24 7835 Austin Avenue ) Burbank, Illinois 60459 ) ) ORDER
INSTRUCTIONS FOR SEALING/EXPUNGING AN ADULT CRIMINAL COURT RECORD
INSTRUCTIONS FOR SEALING/EXPUNGING AN ADULT CRIMINAL COURT RECORD Complete the following paperwork for this process: Step 1. Florida Department of Law Enforcement (FDLE) Certificate of Eligibility packet
ASSOCIATED LICENSEE LOAN MODIFICATION CONSULTANT, FORECLOSURE CONSULTANT AND COVERED SERVICE PROVIDER APPLICATION FOR RENEWAL OF LICENSE AND CHECKLIST
STATE OF NEVADA DEPARTMENT OF BUSINESS AND INDUSTRY DIVISION OF MORTGAGE LENDING 1830 College Parkway, Suite 100 Carson City, NV 89706 (775) 684-7060 Fax (775) 684-7061 www.mld.nv.gov ASSOCIATED LICENSEE
VIDEO GAMING TERMINAL COLLATERAL LENDER REGISTRATION FORM (Pursuant to Video Gaming Adopted Rule 1800.930)
ILLINOIS GAMING BOARD 160 North LaSalle Street, 3 rd Floor Chicago, Illinois 60601 312-814-4700 VIDEO GAMING TERMINAL COLLATERAL LENDER REGISTRATION FORM (Pursuant to Video Gaming Adopted Rule 1800.930)
APPLICATION FOR INVOLUNTARY CUSTODY FOR MENTAL HEALTH EXAMINATION [West Virginia Code: 27-5-2]
IN THE CIRCUIT COURT OF COUNTY, WEST VIRGINIA For Clerk's Use Only IN RE: INVOLUNTARY HOSPITALIZATION OF, RESPONDENT DATE: CASE NUMBER - MH - If this application is GRANTED, distribute copies of the application
DUSTIN McDANIEL ATTORNEY GENERAL OFFICE OF THE ATTORNEY GENERAL 323 CENTER STREET, Suite 200 LITTLE ROCK, AR 72201-2610 (501) 682-2007
DUSTIN McDANIEL ATTORNEY GENERAL OFFICE OF THE ATTORNEY GENERAL 323 CENTER STREET, Suite 200 LITTLE ROCK, AR 72201-2610 (501) 682-2007 PAID SOLICITOR APPLICATION FOR REGISTRATION Pursuant to Ark. Code
NOTICE TO GRANDPARENT
A Power of Atrney may be created if the parent, guardian, or cusdian of the child is any of the following: 1. Seriously ill, incarcerated, or about be incarcerated 2. Temporarily unable provide financial
State of Tennessee Department of Commerce & Insurance Division of Consumer Affairs
State of Tennessee Department of Commerce & Insurance Division of Consumer Affairs INITIAL APPLICATION Debt-Management Services Provider License Only applicants with complete applications are eligible
Facade Grant Program APPLICATION
C I T Y O F E A S T C H I C A G O North Harbor Facade Grant Program APPLICATION The City of East Chicago will fund up to 80% of the cost for facade improvements for properties in designated areas within
South Carolina Name Change Request Packet
South Carolina Name Change Request Packet This packet was created in an effort to assist transgender people in navigating the sometimes overwhelming process of undergoing a legal name change in the state
LICENSING PROCEDURES FOR AUTOMOBILE CLUB AGENTS (MOTOR CLUB AGENTS)
LICENSING PROCEDURES FOR AUTOMOBILE CLUB AGENTS (MOTOR CLUB AGENTS) Requirements for an Automobile Club (Motor Club) Agent License (1) Completed, signed and notarized application (2) $20.00 filing fee
1611 E. PFENNIG LN., P.O. BOX 679 PFLUGERVILLE, TEXAS 78691-0679 PFLUGERVILLE POLICE DEPARTMENT INSTRUCTIONS
IDENTITY THEFT INFORMATION / CREDIT CARD ABUSE PACKET PFLUGERVILLE POLICE DEPARTMENT 1611 E. PFENNIG LN., P.O. BOX 679 PFLUGERVILLE, TEXAS 78691-0679 INSTRUCTIONS The Pflugerville Police Department is
SELLER TRAINING INTERNET-BASED BRANCH SCHOOL CERTIFICATE APPLICATION FORM ST-401IBB (02/2011)
INTERNET-BASED BRANCH SCHOOL CERTIFICATE APPLICATION FORM ST-401IBB (02/2011) REQUIREMENTS: A branch internet-based seller server school certificate is required for each domain that offers a different
APPLICATION FOR A YACHT AND SHIP EMPLOYING BROKER, BROKER OR SALESPERSON'S LICENSE
APPLICATION FOR A YACHT AND SHIP EMPLOYING BROKER, BROKER OR SALESPERSON'S LICENSE Attached please find the application for a yacht and ship employing broker, broker or salesperson's license. Once received,
WEBB COUNTY APPLICATION/AFFIDAVIT Criminal Felony, Misdemeanor or Juvenile Courts Attorney Appointment Rotation List
WEBB COUNTY APPLICATION/AFFIDAVIT Criminal Felony, Misdemeanor or Juvenile Courts Attorney Appointment Rotation List PLEASE COMPLETE THIS ENTIRE PAGE Date: Name: Birth Date: Business Address: Day Phone:
ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION
MEMORANDUM TO: ALL LOAN BROKERS AND ORIGINATORS DOING BUSINESS IN INDIANA FROM: OFFICE OF SECRETARY OF STATE TODD ROKITA, SECURITIES DIVISION RE: LICENSING AND REGISTRATION REQUIREMENTS FOR LOAN BROKERS
APPLICATION FOR ATTORNEY BOND ACCOUNT OF SUBMITTED FOR CONSIDERATION BY THE DALLAS COUNTY SHERIFF S DEPARTMENT
APPLICATION FOR ATTORNEY BOND ACCOUNT OF SUBMITTED FOR CONSIDERATION BY THE DALLAS COUNTY SHERIFF S DEPARTMENT DALLAS COUNTY SHERIFF S DEPARTMENT ATTORNEY BOND ACCOUNT CHECK OFF LIST TO OPEN AN ATTORNEY
NEW/RENEWAL APPLICATION FOR PAIN MANAGEMENT CLINIC REGISTRATION
Department of Regulatory and Economic Resources Business Affairs Division Office of Consumer Protection 601 NW 1st Court, 18th Floor Miami, Florida 33136 Tel: 786-469-2300 Fax: 786-469-2311 email: [email protected]
DEPARTMENT OF HEALTH. APPLICATION FOR LIMITED LICENSURE and Instructions
DEPARTMENT OF HEALTH BOARD OF CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MENTAL HEALTH COUNSELING APPLICATION FOR LIMITED LICENSURE and Instructions APPLICATION FOR LIMITED LICENSURE INSTRUCTIONS
Huron County Juvenile Court
Huron County Juvenile Court Instructions for: CHILD CARE POWER OF ATTORNEY AND CARETAKER AUTHORIZATION AFFIDAVIT This packet was prepared for your convenience and ease in filing a child care power of attorney
Claim Form. Before you fill out this application, please read the information below. Before you complete this application:
Claim Form Before you fill out this application, please read the information below. You may qualify to receive payment if: Before you complete this application: The victim suffered physical injury or was
REQUIREMENTS ON TEMPORARY TRIAL CARD FOR QUALIFIED LAW STUDENTS AND QUALIFIED UNLICENSED LAW SCHOOL GRADUATES
REQUIREMENTS ON TEMPORARY TRIAL CARD FOR QUALIFIED LAW STUDENTS AND QUALIFIED UNLICENSED LAW SCHOOL GRADUATES Read the enclosed Rules and provisions carefully. There are separate forms that need to be
INSTRUCTIONS FOR FILING A CONDOMINIUM / COOPERATIVE COMPLAINT
INSTRUCTIONS FOR FILING A CONDOMINIUM / COOPERATIVE COMPLAINT Submitting your complaint on a Condominium / Cooperative Complaint form legibly printed or typed all of the information you supply on the form
COMMONWEALTH OF PENNSYLVANIA INSURANCE DEPARTMENT REGISTRATION REQUIREMENTS FOR PURCHASING GROUPS
COMMONWEALTH OF PENNSYLVANIA INSURANCE DEPARTMENT REGISTRATION REQUIREMENTS FOR PURCHASING GROUPS REGISTRATION REQUIREMENTS FOR PURCHASING GROUPS The Commonwealth of Pennsylvania appreciates your interest
ESCROW ACCOUNT OPTION NOTICE TO BORROWER
ESCROW ACCOUNT OPTION NOTICE TO BORROWER The mortgage interest rate and discount points agreement which you are entering into with Mission Mortgage is based on the assumption that you will be making monthly
GUIDE TO COMPLETING THE FIDELITY GUARANTEE ACCOUNT CLAIM FORM Effective: 10 October 2012
GUIDE TO COMPLETING THE FIDELITY GUARANTEE ACCOUNT CLAIM FORM Effective: 10 October 2012 You must use the attached form if you wish to claim reimbursement for any loss you believe you have suffered as
WEST VIRGINIA DIVISION OF FINANCIAL INSTITUTIONS Notification Required to Become a Supervised Financial Institution
WEST VIRGINIA DIVISION OF FINANCIAL INSTITUTIONS Notification Required to Become a Supervised Financial Institution Please provide the following information and documentation subject to the West Virginia
San Antonio Police Department FORGERY DETAIL 315 S. Santa Rosa SAN ANTONIO, TX 78207 (210)-207-7451 OFFICE (210)-207-4070 FAX
San Antonio Police Department FORGERY DETAIL 315 S. Santa Rosa SAN ANTONIO, TX 78207 (210)-207-7451 OFFICE (210)-207-4070 FAX Identity Theft Packet SAPD case # Assigned Detective: The San Antonio Police
CRIME VICTIM S REPARATION CLAIM FORM INSTRUCTIONS
CRIME VICTIM S REPARATION CLAIM FORM INSTRUCTIONS In order to process your claim for compensation, the following information is needed: 1. The claim for compensation must be thoroughly and accurately completed.
When should this form be used?
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(i), MOTION FOR EXTENSION OF INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE, REPEAT VIOLENCE, DATING VIOLENCE, OR SEXUAL VIOLENCE
INSTRUCTIONS FOR HEARING AID DISPENSING APPLICATION
BOARDS AND COMMISSIONS DIVISION New Mexico Speech-Language Pathology, Audiology and Hearing Aid Dispensing Practices Board PO Box 25101 Santa Fe, New Mexico 87505 (505) 476-4640 Fax (505) 476-4620 www.rld.state.nm.us
BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF:
BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF: DATE SUBMITTED: FOR CONSIDERATION BY THE DALLAS COUNTY BAIL BOND BOARD ** please provide one original and one redacted copy ** DALLAS COUNTY BAIL
CRIME VICTIM ASSISTANCE STANDARDS
V I C T I M S E R V I C E S D I V I S I O N Texas Department of Criminal Justice Victim Services Division CRIME VICTIM ASSISTANCE STANDARDS Developed and distributed by the The Texas Crime Victim Clearinghouse
Hot Check Program 4. INFORMATION TO RECORD ON THE FRONT OF THE CHECK: REMEMBER, always record all information on the front of the check.
Hot Check Program The Bandera County Attorney s Office is charged with the responsibility of helping merchants recover lost funds due to bad checks. Enclosed is an information packet along with a sample
GUARANTY BOND SAMPLE. correspondence school seeks from the State Board of Community Colleges licensure to
Guaranty Bond Page 1 STATE OF NORTH CAROLINA Bond No. COUNTY OF GUARANTY BOND KNOW ALL PERSONS BY THESE PRESENT THAT: WHEREAS, A proprietary business school, or proprietary trade school or proprietary
POWER OF ATTORNEY., the parent(s), the undersigned, residing at, in the county of, state of, hereby appoint the child s
POWER OF ATTORNEY Case No. I/we,, the parent(s) of, the undersigned, residing at, in the county of, state of, hereby appoint the child s grandparent,, residing at, in the state of Ohio, with whom the child
DEPARTMENT OF COMMERCE DIVISION OF FINANCIAL INSTITUTIONS
STATE OF MINNESOTA DEPARTMENT OF COMMERCE DIVISION OF FINANCIAL INSTITUTIONS RE: CONSUMER SMALL LOAN LENDER ACT Application may be made on the attached forms for a Consumer Small Loan Lending license pursuant
VIEJAS BAND OF KUMEYAAY INDIANS TRIBAL CODE TORT LIABILITY ORDINANCE. Enacted 11-20-2013. Table of Contents
VIEJAS BAND OF KUMEYAAY INDIANS TRIBAL CODE TORT LIABILITY ORDINANCE Enacted 11-20-2013 Table of Contents Section 1 General Provisions... 1 1.01 Purpose... 1 1.02 Exclusive Remedy.... 1 1.03 Effective
Industry-Funded Consumer Protection. Considering a Claim? Frequently Asked Questions. What is the Motor Vehicle Dealers Compensation Fund?
Industry-Funded Consumer Protection Frequently Asked Questions 1 FAQs What is the Motor Vehicle Dealers Compensation Fund? The Motor Vehicle Dealers Compensation Fund (the Fund) reimburses eligible consumers
TRONOX TORT CLAIMS TRUST. Individual Review and Arbitration Procedures for Category A and Category D Personal Injury Claims
TRONOX TORT CLAIMS TRUST Individual Review and Arbitration Procedures for Category A and Category D Personal Injury Claims Pursuant to Sections 3.4 and 3.5 of the Tronox Tort Claims Trust Distribution
Minnesota Appraisal Management Company License Application Required Forms
MINNESOTA DEPARTMENT OF COMMERCE 85 7th PLACE EAST, SUITE 500 ST. PAUL, MINNESOTA 55101 (651) 539-1599 Appraisal Management Company Application Required Forms Minnesota Statute 82C Minnesota Appraisal
SOUTH DAKOTA DIVISION OF INSURANCE 124 S Euclid Ave, 2 ND Floor Pierre, South Dakota 57501 (605) 773-3563 http://dlr.sd.
SOUTH DAKOTA DIVISION OF INSURANCE 124 S Euclid Ave, 2 ND Floor Pierre, South Dakota 57501 (605) 773-3563 http://dlr.sd.gov/insurance Purchasing Group (PG) Registration To Do The Business of Insurance.
corporation with its principal place of business in the City of
TEXAS DEPARTMENT OF INSURANCE Division of Workers Compensation Self-Insurance Regulation MS-60 7551 Metro Center Dr., Ste 100 Austin, Texas 78744-1645 (512) 804-4775 FAX (512) 804-4776 www.tdi.texas.gov
HOW TO OBTAIN A NEW CONTRACTOR LICENSE
HOW TO OBTAIN A NEW CONTRACTOR LICENSE These instructions apply to new licenses only. If you wish to add a classification or a qualifying party to an existing license, please see HOW TO ADD A CLASSIFICATION
Please contact 800.854.9846 if you have additional questions regarding your claim.
Upon receipt of this completed packet, Kinecta Federal Credit Union will research your claim. The Credit Union will resolve your claim within 10 business days or will contact you directly for additional
How to Clear an Arrest from Your Record in Texas (Expunction)
How to Clear an Arrest from Your Record in Texas (Expunction) Can I clear an arrest from my record? You may be able to clear an arrest from your record through a process called expunction if: charges were
PIERCE COUNTY DISTRICT COURT 930 TACOMA AVE S, Room 239, TACOMA, 98402. Small Claims Information
930 TACOMA AVE S, Room 239, TACOMA, 98402 Small Claims Information A Small Claims case can be filed for the recovery of money only. This amount cannot exceed $5,000. LEGAL ADVICE The clerk will assist
INSTRUCTIONS PETITION FOR EXPUNGEMENT OF CRIMINAL RECORDS PROVIDED UNDER W.VA. CODE 61-11-26
INSTRUCTIONS PETITION FOR EXPUNGEMENT OF CRIMINAL RECORDS PROVIDED UNDER W.VA. CODE 61-11-26 Petition Form Carefully read the attached form to fill out your Petition for Expungement of Criminal Records
State of Utah DEPARTMENT OF COMMERCE DIVISION OF CONSUMER PROTECTION
State of Utah DEPARTMENT OF COMMERCE DIVISION OF CONSUMER PROTECTION CERTIFICATE OF POSTSECONDARY STATE AUTHORIZATION: PUBLIC NONPROFIT POSTSECONDARY SCHOOL APPLICATION (continuous operation for at least
ENCLOSED ARE THE FORMS NECESSARY FOR APPLICATION
TEXAS MEDICAL INSURANCE COMPANY ENCLOSED ARE THE FORMS NECESSARY FOR APPLICATION Applicant must be employed and supervised by a TMLT insured physician. Complete and sign the Application for Coverage. Complete
BUSINESS PARTNER AUTHORIZATION CHECKLIST
BUSINESS PARTNER AUTHORIZATION CHECKLIST Thank you for choosing Direct Commercial Funding, Inc., Where Funding Never Stops. The Authorization documents listed below must be completed prior to closing.
corporation with its principal place of business in the City of
TEXAS DEPARTMENT OF INSURANCE Division of Workers Compensation Self-Insurance Regulation MS-60 7551 Metro Center Dr., Ste 100 Austin, Texas 78744-1645 (512) 804-4775 FAX (512) 804-4776 www.tdi.texas.gov
APPLICATION FOR NATIONAL EXAMINATION IN MARITAL & FAMILY THERAPY
Minnesota Board of Marriage and Family Therapy 2829 University Avenue SE, Suite 400 Minneapolis, MN 55414-3222 Telephone: (612) 617-2220 Fax: (612) 617-2221 Email: [email protected] Website: www.bmft.state.mn.us
RULE 4-1.5 FEES AND COSTS FOR LEGAL SERVICES
RULE 4-1.5 FEES AND COSTS FOR LEGAL SERVICES (a) Illegal, Prohibited, or Clearly Excessive Fees and Costs. [no change] (b) Factors to Be Considered in Determining Reasonable Fees and Costs. [no change]
IMPORTANT LEGAL NOTICE
IMPORTANT LEGAL NOTICE MAIL THE COMPLETED AND SIGNED FORM AND ALL OF YOUR DOCUMENTATION TO: SAN ANTONIO INDEMNITY COMPANY IN RECEIVERSHIP MILFORD CONSULTING, LLC, SPECIAL DEPUTY RECEIVER P.O. Box 279,
State of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division
State of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division CLEET Private Security Division Ada, Oklahoma 74820-0669 (405) 239-5100 Dear Agency Applicant: Thank
CODE ENFORCEMENT BOARD CITY OR ORLANDO REQUEST FOR REDUCTION OF PENALTY
CODE ENFORCEMENT BOARD CITY OR ORLANDO CEB CASE NO. REQUEST FOR REDUCTION OF PENALTY By completing this form, you are making statements under oath. Failure to be truthful is a violation of Orlando City
HARRIS COUNTY SHERIFF'S DEPARTMENT ATTORNEY'S BAIL BOND APPLICATION 1. NAME OF APPLICANT: BAR CARD # DATE OF BIRTH: DL#
DATE APPLICATION PREPARED: HARRIS COUNTY SHERIFF'S DEPARTMENT ATTORNEY'S BAIL BOND APPLICATION 1. NAME OF APPLICANT: BAR CARD # DATE OF BIRTH: DL# 2. BUSINESS ADDRESS: PHONE # ( ) CITY: ZIP: EMAIL: HOME
COLLINGSWOOD BOARD OF EDUCATION 200 LEES AVENUE COLLINGSWOOD, NJ 08108 REQUEST FOR PROPOSAL/EUS
COLLINGSWOOD BOARD OF EDUCATION 200 LEES AVENUE COLLINGSWOOD, NJ 08108 REQUEST FOR PROPOSAL/EUS A. PURPOSE: The Collingswood Board of Education is seeking proposals through the EUS procurement process
HOW TO FILE A PETITION TO EXPUNGE JUVENILE OFFENSES
HOW TO FILE A PETITION TO EXPUNGE JUVENILE OFFENSES Disclaimer Neither the staff in Court Administration nor the staff in any Court office will be able to give you legal advice or help you fill out/complete
INSTRUCTIONS FOR ALABAMA STATE BOARD OF ADJUSTMENT CLAIM FOR ON THE JOB INJURY www.bdadj.alabama.gov
INSTRUCTIONS FOR ALABAMA STATE BOARD OF ADJUSTMENT CLAIM FOR ON THE JOB INJURY www.bdadj.alabama.gov NOTE: Claims must be presented to the Alabama State Board of Adjustment within one year after the date
CARDTRONICS, INC. POLICY ON COMPLIANCE WITH SHORT-SWING TRADING AND REPORTING LAWS. Amended and Restated as of November 13, 2013
CARDTRONICS, INC. POLICY ON COMPLIANCE WITH SHORT-SWING TRADING AND REPORTING LAWS Amended and Restated as of November 13, 2013 THIS SHORT-SWING TRADING AND REPORTING POLICY APPLIES TO ALL DIRECTORS AND
License Application for a Life Settlement Provider or Broker
License Application for a Life Settlement Provider or Broker The Life Settlement Provider s and Broker s application requires four (4) categories of information: Section I Application Form and Fee Section
ENDURING POWER OF ATTORNEY
ENDURING POWER OF ATTORNEY Made under Part 2 of the Power of Attorney Act. The use of this form is voluntary. Be advised that this form may not be appropriate for use by all persons, as it provides only
When should this form be used?
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(j), MOTION FOR MODIFICATION OF INJUNCTION FOR PROTECTION AGAINST DOMESTIC VIOLENCE, REPEAT VIOLENCE, DATING VIOLENCE, OR SEXUAL VIOLENCE
ATTORNEY-CLIENT WORKERS COMPENSTATION FEE CONTRACT AND AUTHORIZATION TO REPRESENT
STATE OF GEORGIA ATTORNEY-CLIENT WORKERS COMPENSTATION FEE CONTRACT AND AUTHORIZATION TO REPRESENT I,, with a Social Security Number of the undersigned, do hereby retain the Ramos Law Firm, LLC, located
Texas Veterans Housing Assistance and Home Improvement Programs
Texas Veterans Housing Assistance and Home Improvement Programs Certification of Eligibility Application Jerry Patterson, Chairman For assistance, please contact the Texas Veterans Land Board toll free
Leander Police Department 705 Leander Dr Leander, Texas 78641 (512) 528-2800
Leander Police Department 705 Leander Dr Leander, Texas 78641 (512) 528-2800 Identity Theft Information and Affidavit The attached Identity Theft Affidavit packet has been given to you because you may
Documents Required. $400 due diligence check per company made payable to Capstone Business Funding, LLC
Legal Business Name Date Documents Required Current Accounts Receivable Aging Report Company Information Application and Origination Statement (Have your signature notarized under Origination Statement
REQUIREMENTS WHEN FILING COMPLAINT
REQUIREMENTS WHEN FILING COMPLAINT 1. The complainant (person making the complaint) must, in good faith, make full, fair, and honest disclosure of all facts and circumstances known to him/her at the time
How To Get A Home Loan From The Veterans Land Board
Texas Veterans Home Loan and Home Improvement Programs Certification of Eligibility Application Jerry Patterson, Chairman For assistance, please contact the Texas Veterans Land Board toll free at 1-800-252-VETS
LICENSE FEE: $300 fee must be submitted at the time of application. Make checks payable to: City of Milwaukee.
ccl-160 (12/10) PRIVATE ALARM BUSINESS LICENSE INFORMATION SHEET OFFICE OF THE CITY CLERK LICENSE DIVISION 200 E. WELLS ST. ROOM 105, MILWAUKEE, WI 53202 (414) 286-2238 E-MAIL ADDRESS: [email protected]
APPLICATION FOR DUI COURT
IN THE COURT OF COMMON PLEAS OF CENTRE COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA OTN # v CP-14-CR- - (name of applicant) APPLICATION FOR DUI COURT the District Attorney of Centre County I,, defendant
"# $% & $ % $$ "$ ' '((!) * % ( * % '+( ((* % ,-- (- (. ) * % () ) ( / &0#!!0 &102!
!"#$ % $!&& ! "# $% & $ % $$ "$ ' '((! * % ( * % '((* % '+( ((* %,-- (- (. * % ( ( / &0#!!0 &102! (" * +, -., %3 0 4 5 6 5 7 (- - 8 879 5 7 85 5 :(; . 59 $. *"/ *. (@. +. A. (.. A '+. (8(..
SUPERIOR COURT OF THE DISTRICT OF COLUMBIA CRIME VICTIMS COMPENSATION PROGRAM 515 Fifth Street, N.W., Suite 109 Washington, D.C.
SUPERIOR COURT OF THE DISTRICT OF COLUMBIA CRIME VICTIMS COMPENSATION PROGRAM 515 Fifth Street, N.W., Suite 109 Washington, D.C. 20001 APPLICATION FOR CRIME VICTIMS COMPENSATION DATE RECEIVED: CLAIM NUMBER:
PROTECTIVE ORDER UNIT QUESTIONNAIRE FANNIN COUNTY CRIMINAL DISTRICT ATTORNEY S OFFICE
PROTECTIVE ORDER UNIT QUESTIONNAIRE FANNIN COUNTY CRIMINAL DISTRICT ATTORNEY S OFFICE HOW TO USE THE QUESTIONNAIRE USE BLACK INK ONLY blue ink and other colors of ink are difficult to read, especially
DIVISION OF BANKING 1511 Pontiac Avenue, Building 68-2 Cranston, Rhode Island 02920. Telephone (401) 462-9503 - Facsimile (401) 462-9532
DIVISION OF BANKING Cranston, Rhode Island 02920 TO: RE: Telephone (401) 462-9503 - Facsimile (401) 462-9532 LENDER, SMALL LOAN LENDER AND LOAN BROKER LICENSEES FINAL ANNUAL REPORT PLEASE READ ALL DOCUMENTS
Grievances Against Lawyers & Judges
Where do I file a grievance against a lawyer or judge THE COLUMBUS BAR ASSOCIATION Ethics Grievances An ethics grievance against a lawyer or a judge must be in writing and filed with one of the following
City of Houston, Texas, Ordinance No. 2013-
City of Houston, Texas, Ordinance No. 2013- AN ORDINANCE AMENDING CHAPTER 28 OF THE CODE OF ORDINANCES OF HOUSTON, TEXAS, RELATING TO CONSUMER PROTECTION AND REGULATION OF CREDIT ACCESS BUSINESSES; CONTAINING
Claim Form. Before you fill out this application, please read the information below. You may qualify for payment if:
Claim Form Before you fill out this application, please read the information below. This claim form should be submitted within one year of the crime. Please include a letter explaining the delay, if more
APPLICATION FOR EMANCIPATION
Revised 04.22.13 APPLICATION FOR EMANCIPATION PINAL COUNTY TO REQUEST A COURT ORDER FOR EMANCIPATION OF A MINOR INSTRUCTIONS AND FORMS Provided as a Public Service by Amanda Stanford Clerk of the Superior
Asking the Court to Appoint a Lawyer for You in a Lawsuit to Terminate Your Parental Rights
Asking the Court to Appoint a Lawyer for You in a Lawsuit to Terminate Your Parental Rights Note: Use these forms and instructions to ask the court to appoint a lawyer for you in a lawsuit requesting termination
MEMORANDUM. Requirements Under Liability Risk Retention Act of 1986 and Nebraska Risk Retention Act
MEMORANDUM TO: FROM: SUBJECT: All Purchasing Groups Proposing to Transact Business in Nebraska Department of Insurance Requirements Under Liability Risk Retention Act of 1986 and Nebraska Risk Retention
Mortgage Banker/Mortgage Broker/Mortgage Loan Servicer Questionnaire
N E W Y O R K S T A T E DEPARTMENTOF FINANCIAL SERVICES Mortgage Banker/Mortgage Broker/Mortgage Loan Servicer Questionnaire Personal/Contact Information Please fill in electronically or print and fill
