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Forms 1- 20 of 80 Available for 'Misc'

Notice of Litigation to Party Answerable  

An action has been brought against the undersigned, _ (defendant), of _ (address), _ (city), _ County, _ (state), in the _ Court of _ County, Docket No. _, on a negotiable instrument on which the undersigned may be liable in the capacity of _. You are liable on this instrument in the capacity of _, and you are also liable over to the undersigned if the undersigned is held liable in this action.

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Consent for Emergency Medical Or Surgical Treatment  

____ (Name of Patient) is in need of immediate medical or surgical treatment. We, the undersigned, consider the treatment necessary to preserve _ (His or Her) life or health. Having been unable to do so within a reasonable time, we certify that, in our professional judgment, any further delay in the performance of medical treatment or an emergency operation on this patient would seriously increase the danger to _ (His or Her) life or health.

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Extra Work Order  

[ ] The work below to be paid for at actual cost of labor, materials and equipment plus ___ percent ( _% ). ________ ________ ________ ________ The work covered by this order shall be performed under the same Terms and Conditions as that included ...

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Insurance Claim Notice  

You are hereby notified that we have incurred a loss covered by insurance you underwrite. The claim information is as follows: Please forward a claim form or have an adjuster call me at the telephone number below.

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Notice of Completion  

1. The undersigned is an owner or agent of an owner of the interest or estate stated below. 4. The nature of the interest or estate of the owner is;____ in fee (If other than fee, strike "in fee" and insert, for example, "Purchaser Under Contract of Purchase," or "Lessee"). 6. A work of improvement on the property hereinafter described was completed on _____.

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Notice of Non-responsibility  

1. The undersigned is an owner of the interest or estate stated below. 8. The undersigned will not be responsible for any claims arising from the work of improvement on the herein described property. I am __ the ____ (President, Agent, etc.) owner of the aforesaid interest or estate in the property described in the above notice; I have read the foregoing notice and know and understand the contents thereof, and the facts stated herein are true and correct.

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Stop Notice  

has performed labor and furnished materials for a work of improvement described as follows: _____ (address of the project). Total value of the whole amount of labor and materials agreed to be furnished is ____ Dollars ($___). The value of the labor and materials furnished to date is __ Dollars ($___).

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Additional Description Form  

ADDITIONAL DESCRIPTION FORM The following is an additional description of the contract between the above named parties dated: _, (month & day) __ (year): OWNER'S OR AGENT'S SIGNATURE DATE

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Physician Release of Medical Information  

Please be advised that I, ______ (Name), have retained the firm of ____, attorneys at law, to represent me in a claim for personal injuries and/or property damage which resulted from an accident that occurred on _ (Date). You are authorized to furnish to them any and all information they may request concerning my injuries, including, but not limited to, photocopies of any medical records and/or reports. This ...

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Release of Records  

FOR ATTORNEY TO INSPECT AND COPY Patientïs Name and Address: ___ This is authority for you to permit ____ (name), my attorney, to copy, inspect, and examine any and all records, charts, reports, X-rays, and X-ray reports that may be at your hospital pertaining to my ____ (injuries or illness) for which I was admitted on __ (month & day), _ (year), and confined until ___ (month &am

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Acknowledgment of Receipt of Goods  

The undersigned hereby acknowledges receipt and delivery of the following goods ______ and further acknowledges that said goods have been inspected and are without defect. Signed and sealed this __ day of __ (month), __ (year).

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Surety Bond  

Surety bond by ____ as principal, and as surety, a corporation incorporated under the laws of the State of __ ___, and licensed to transact a surety business in the State of _ ____, to ___, as obligee. A. Principal and surety are bound to obligee in the sum of ____ ($__), for the payment of which principal and surety jointly and severally bind themselves, their successors...

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Shipping Notice  

Under separate cover we have shipped the items ordered on your purchase order number _. Should these items not arrive shortly thereafter, please contact us so we may track them. We look forward to doing business with you in the future.

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Refusal to Permit Medical Treatment And/or Operation  

I, ______ (name), being a patient at ____ (name of hospital) have been advised by Dr. __, my attending physician, as to the advisability of, the risk and complications inherent in, the expected benefits of, as well as the alternatives to and their risks and benefits, and the probable consequences of not receiving the following medical treatment or operation: ___ (describe ...

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Agreement Extending A Contract  

extension of an original agreement dated ___ (month & day), _ (year) due to conclude on ___ (month & day), _ (year) will be made on this ___ day of ___ (month), _ (year). 2. In all other respects, said agreement shall continue in full force and effect. IN WITNESS WHEREOF, the parties have executed this agreement on the day and year first above written.

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Consent to Medical Treatment and Operation  

I, ____ (Name), being a patient at ____ (Hospital), having been fully informed by Dr. ___, a physician and surgeon, of the risks and possible consequences involved in certain medical and surgical treatment consisting of _____, hereby consent to and authorize the administration and performance of such treatment and operation at _____ (Hospital), including the arrangements for...

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Waiver of Right to Cancel  

I, _____, having initiated a contract with __ in connection with emergency repairs or service, for the protection of persons and/or real or personal property, do hereby declare that an emergency situation exists at __ _____ described as follows, which requires immediate attention: ______. I acknowledge and hereby waive all rights to cancel this contract within three (3) business days...

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Seller's Order Conformation  

All such taxes, and any other taxes measured, in whole or part, by gross receipts applicable to this transaction are to be borne by the purchaser. All export, import and other duties, tariffs and customs shall be paid by the purchaser. If exemption is claimed by the purchaser from any of the foregoing, the purchaser shall furnish satisfactory proof of such exemption.

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Acceptance of An Order  

We are in receipt of your purchase order #____. We will fill this order in _ (___) days as noted above, unless you state otherwise beforehand. We look forward to doing business with you again in the future.

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Physician Release of Medical Information  

Please be advised that I, ______ (name), have retained the firm of ___, Attorneys at Law, to represent me in a claim for personal injuries and/or property damage which resulted from an accident that occurred on __ (month & day), _ (year). You are authorized to furnish to them any and all information they may request concerning my injuries, including, but not limited to, photocopies of any medical ...

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