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Search results with tag "Xxxxxxx"

636355B SM N611v,N811v v04 - Norcold

636355B SM N611v,N811v v04 - Norcold

norcold.com

x.xx . e xxx VOLTS - AC xx HZ x.xx AMPS xxx Watts xx VDC xx HZ x.x AMPS xx xx Watts oup Code e BTUH ant tified Explanation 1 N = Norcold ... xxx xxxxxxx x xxxxxxxxxxx xxxxxxxxx xxxx x xxxxxx xxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxx D E SIG N C ERT …

  Xxxxxx, Xxxx, Xxxxxxx, Xxx x, Xxxxxxx x xxxxxxxxxxx, Xxxxxxxxxxx, Xxxx x xxxxxx

TÍTULO DA MONOGRAFIA - MonografiaPronta.COM

TÍTULO DA MONOGRAFIA - MonografiaPronta.COM

www.mepeldigitus.com

14 METODOLOGIA X X Xxxxxxxxxxxx (Fonte12) xxxxxxxxxx xxxxx xxxxx xxxxxx xxxxx xxxxx xxxxx xxxxxxx xxx xxx xxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxx xxx

  Xxxxx, Xxxxxxxxxx, Xxxxxxxxxx xxxxxx xxxx, Xxxxx xxxxx xxxxx xxxxxxx xxx, Xxxxxxx

MODELO PARA ELABORAÇÃO DE PROJETOS DE TRABALHOS …

MODELO PARA ELABORAÇÃO DE PROJETOS DE TRABALHOS …

www.unicap.br

CURSO DE XXXXXXXX XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXX (título da monografia e subtítulo, se houver) ... XXXXXXX XXXXXX XXXXXX Tabela 6. ... XXXX Tabela 9. MODELO PARA ELABORAÇÃO DE PROJETOS DE TRABALHOS ACADÊMICOS Virgínia Colares 14

  Xxxxxxxxxxxxxxxxxxx, Xxxxxx, Xxxx, Xxxxxxx, Xxxxxxxx, Xxxxxxx x xxxxxxxxxxx

“idem” No campo “Atividades desenvolvidas pelo Estagiário ...

“idem” No campo “Atividades desenvolvidas pelo Estagiário ...

aluno.ibresp.com.br

CNPJ: xx.xxx.xxx/xxxx-x CRECI: xxxxxxx PJ Endereço: xxxxxxxxxxxxxx,xx Bairro: xxxxxxxxxxxxxxxxxxxxxxxxx Município: xxxxxxxxxxxxxxxxxx UF: xx CEP: xxxxx-xxx Telefone: (xx ) xxxx-xxxx Celular: ( xx ) xxxxx-xxxx E-mail: exemplo@exemplo.com.br SUPERVISOR DO ESTÁGIO: (PREENCHIMENTO OBRIGATÓRIO )

  Xxxx, Xxxxxxx

Information on residency for tax purposes

Information on residency for tax purposes

www.oecd.org

xxxxxxxxxxxdxxxxxloocxxxxxxxj(j(j(j(j{l(xx:xxxxxxxx xxx· xxxxxxxxxxxxxxxxxxxxxl xx xxxxxx 01235.618901234.6:78j01· 23457 ' 567.890.12'3 8901234 xxxxxxx)(xxxxxx·xxxxxjp.t>sc:x*xxx· )(xxxxxxxxxxxx·)(x s6789or2j4567a9ol23 678'901234561890123

  Xxxxxx, Xxxxxxx, Xxxx xxxx

www.esic.nic.in

www.esic.nic.in

www.esic.nic.in

Allotted dispensary XXX)(XX)(XXX Residential Address: xxxxxxx fàfù: xxxxxxx Particular of Dependents: S.N0. Name GOVT. OF INDIA, MINISTRY OF LABOUR & EMPLOYMENT EMPLOYEES' STATE INSURANCE CORPORATION / Office E.S.I.C. NiRAT/Employee No. XXXXXXXXXXXXXXX Name of Dependent xxxxxxxxxxxxxxxxxxxxxx XXXXXXXXXXXXX …

  Xxxxxxx

+ 8 9 - SPS PRO

+ 8 9 - SPS PRO

www.sps-pro.com

n (˚˘˘˚˘ s e *ˆ*ˇ&+#˚ &,#ˆ˚ xx xxxxxxxxx xxxxxxx xxxxxxx xxxxxxxxxxxx X-- -- -- -- -- ./ !0 .1 "/ 11 xxxxxxx xxxxxxxxxxxx x-- -- -- -- -- xx xxxxxxxxx xxxxxxx

  Xxxxxxx, Xxxxxxxxxxxx, Xxxxxxx xxxxxxx xxxxxxxxxxxx x, Xxxxxxxxxxxx x

Missouri Certificate of Title

Missouri Certificate of Title

dor.mo.gov

xxx 9999 X xXxXxXX Xx 0001-001 XXXX XXXXXXX XXXXXXXX XXXXXXX 999 xxxxxxx XX XXXX XXXXXX MO 99999-9999 VEHICLE SUBJECT TO FOLLOWING LIEN(S) PAID VOID To e xxxxxxx xxxx x XX x XXXXX XX xxx xxxxxxx 99999 99/99/2017

  Missouri, Xxxxx, Xxxxxx, Xxxx, Xxxxxxx, Xxxxxxx xx xxxx xxxxxx, Xxxxxxx xxxx x xx x xxxxx xx xxx xxxxxxx

CONTRATO DE TRABAJO INDEFINIDO - Lean Case blog

CONTRATO DE TRABAJO INDEFINIDO - Lean Case blog

mag.leancase.co

Cargo del (la) Trabajador(a): XXXXXXXXXXXX E.P.S: XXXXXXXXXXXX A.F.P: XXXXXXXXXXXX A.R.L: XXXXXXXXXXXX ( N ombre del empleador ) identificado con Nit No. X XXXXXXX representado legalmente por XXXXXXXXXX i dentificado con cédula de ciudadanía No. X XXXXXXXXXXXX, con domicilio

  Xxxxxxx, Xxxxxxxxxxxx, Xxxx xxxx, Xxxxxxxxxxxx x

Contrato Social - Modelo CONTRATO SOCIAL CLÁUSULA …

Contrato Social - Modelo CONTRATO SOCIAL CLÁUSULA …

www.cartoriosarlo.com.br

XXXXXXXXXXXXXXXXXXXXXXX xxxx xxxx 100 Total do Capital Social xxxx xxxx 100. Parágrafo primeiro: A responsabilidade do sócio único é restrita ao valor de suas quotas, ... residente a Rua/Avenida xxxxxxx, Nº xxxxxx, Bairro xxxxxxxx CEP xxxxxxxx,.cidade de Vitória, Estado do Espírito Santo. ...

  Xxxx, Xxxxxxx, Xxxx xxxx, Xxxxxxxx

ELABORAÇÃO DO PLANO DE ENSINO E DO PLANO DE AULA  …

ELABORAÇÃO DO PLANO DE ENSINO E DO PLANO DE AULA …

www2.unirio.br

PROFESSOR: xxxxxxx ASSUNTO: xxxxxxx EMENTA: Xxxxxxxx CARGA HORÁRIA: ... UNIRIO CENTRO DE CIÊNCIAS HUMANAS E SOCIAIS - CCH ESCOLA DE BIBLIOTECONOMIA CURSO DE LICENCIATURA EM BIBLIOTECONOMIA 1 xxxxxx 2 xxxxxx 3 xxxx METODOLOGIA: xxxxx CONTEÚDO PROGRAMÁTICO: 1 xxxxxxxxxx 2 xxxxxxxxxxxxx 3 …

  Xxxxxx, Xxxxxxx

Physical Therapy Goals XXXXXXXXXXXXX will negotiate a ...

Physical Therapy Goals XXXXXXXXXXXXX will negotiate a ...

einsteinmed.edu

11. XXXXXXXXXXX will creep forward 10’ with minimal assistance, demonstrating cross lateral position . 12. XXXXXXXXXXX will pull self to standing position with minimal assistance 3 x. 13. XXXXXXXXXXXXX will cruise 15’ with supervision. 14. XXXXXXX will transition from floor to stand with BUE support and supervision 3X consecutively through ...

  Xxxxxxx, Xxxxxxxxxxx

SINDICÂNCIA - Procedimentos - Novo

SINDICÂNCIA - Procedimentos - Novo

www.uesc.br

mim, xxxxxx, secretário, o interrogado e demais membros, assinado. Campus Prof. Soane Nazaré de Andrade, Ilhéus (Ba), xx de xxx de xxxx. xxxxxxxxxx Interrogado xxxxxxxxxxxxxxx Presidente xxxxxxx Membro xxxxxxxx Membro UNIVERSIDADE ESTADUAL DE SANTA CRUZ UESC Campus Prof. Soane Nazaré de Andrade, Rodovia Ilhéus/Itabuna, Km 16

  Xxxxxx, Xxxx, Xxxxxxx

Power of Attorney (Sample) - ICO Services

Power of Attorney (Sample) - ICO Services

www.icoservices.com

in xxxxxxxxxxxx on the (date of incorporation), registration number (company’s number), and having its registered office at x xxxxxxxxxxxxxxxxxx. Director of the Company do hereby constitute and appoint: (name of the beneficial owner), born on ... Director of XXXXXXX (name of the company) Title: Power of Attorney (Sample)

  Power, Samples, Attorney, Power of attorney, Xxxxxxx, Xxxxxxxxxxxx

20XX X月X 20XX X XX

20XX X月X 20XX X XX

www.kantei.go.jp

xx. の製造、販売: xxx.x% イ 役員の兼任. x: 名 (間接出資子会社) xxxセグメント. xxxxxxxxx. ㈱: 大阪府xx. 市 xxx. 億円: xx. 加工品等の製 造、販売: xxx.x% (xxx.x%) xxxxxxxxxxxxxxx社 アメリカ. xxx米ドル xxxxxxx. の製造、 販売: xxx.x% (xxx.x%) (注

  Xxxxxxx, Xxxxxxxxx

PROBLEM SOLVING - Stellenbosch University

PROBLEM SOLVING - Stellenbosch University

academic.sun.ac.za

xxxxxxx xx x x x x xxxxxxx xx xxxxxxxxxx xxxxxxxxxx x x 10 tables 18 tables One large table Of the many descriptions of problem-solving strategies, some of the best known can be found in the work of Polya (1957). Frequently sited strategies include using diagrams, looking for patterns, listing all possibilities, trying special values or cases ...

  Xxxxxxx, Xxxxxxx xx x x x x xxxxxxx xx

TERMO ADITIVO AO CONTRATO DE PRESTAÇÃO DE …

TERMO ADITIVO AO CONTRATO DE PRESTAÇÃO DE …

antigo.plataformamaisbrasil.gov.br

Alterar cláusula primeira do CPS nº xx/xxxx, para tratar da aplicação dos Anexos I, II, III e IV aos contratos de repasse celebrados em 2018 e da aplicação dos Anexos I-A, II-A, III-A e IV-A aos ... A UNIÃO, por meio do MINISTÉRIO XXXXXXX, CNPJ nº XXXXXXXX doravante denominada CONTRATANTE, neste ato representada pelo XXXXXXXXX, ou ...

  Xxxx, Xxxxxxx, Xxxxxxxx

INDUSTRIAL TRAINING REPORT GUIDELINE

INDUSTRIAL TRAINING REPORT GUIDELINE

ktn.kptm.edu.my

SESSION : xxxxxxx 201x . i TABLE OF CONTENTS Page Acknowledgement ... 3.1 Introduction x 3.2 Summary of the training and experience gained x ... Encik xxxxxxxxxxxx. He is very kind in person and keen enough to give any newbie his full attention including me. Without his endless care and wit, I wouldn’t have made any ...

  Xxxxxxx, Xxxxxxxxxxxx

SCHEDULE OF CONDITION IN RELATION TO …

SCHEDULE OF CONDITION IN RELATION TO

www.dilapidationsdirect.co.uk

schedule of condition in relation to xxxxxxx xxxxxxxxxx xxxxxx xxxx prepared following inspections on the 27 november & 9 december 2009 by

  Conditions, Schedule, Relations, Xxxxxxx, Schedule of condition in relation to, Schedule of condition in relation to xxxxxxx

V I S T O S SUMARIO CIVIL (PRESCRIPCIÓN …

V I S T O S SUMARIO CIVIL (PRESCRIPCIÓN …

www.stjsonora.gob.mx

ORDINARIO MERCANTIL EXPEDIENTE No. XXXX-2015 6 XXXXXXXXXXXX, en su carácter de acreedor, y por la señora XXXXXXX, como …

  Xxxx, Xxxxxxx

新型コロナウイルス感染症対応 休業支援金・給付金支給申請 …

新型コロナウイルス感染症対応 休業支援金・給付金支給申請 …

www.mhlw.go.jp

xx x xx xxxx xxxxxxx xxx xxxx xxxx xxxxxxx 申請 太郎 xx xx xx 申請 太郎 東京 0-0 マンション 号室 銀行 支店 株式会社 申請 太郎 東京 0-0 6 31 1 30 4 2 2 3 12 1 197480 1 …

  Xxxx, Xxxxxxx, Xx x xxx, Xx x xx xxxx xxxxxxx xxx xxxx xxxx xxxxxxx

Descriptors

Descriptors

fphc.rcsed.ac.uk

Intoxication and poisoning x xx The fitting patient xxxxxxx Acute allergic reaction xxxxxx Acute non‐traumatic neck / back pain x xx Sudden weakness / paralysis / abnormal sensation xxxxxxxx Acute visual disturbance / red eye x xx Acute febrile illness x xx Acute gastrointestinal haemorrhage x xx Acute limb pain and/or swelling x xx

  Xxxxxx, Xxxxxxx

PEDOMAN PENULISAN SKRIPSI - fmipa.usu.ac.id

PEDOMAN PENULISAN SKRIPSI - fmipa.usu.ac.id

fmipa.usu.ac.id

Nomor Induk Mahasiswa : xxxxxxxx Program Studi : Sarjana Xxxxxxx Fakultas : MIPA - Universitas Sumatera Utara 4 spasi Disetujui di Medan, tanggal bulan tahun 2 spasi Ketua Program Studi Pembimbing, Nama Ketua Program Studi Nama pembimbing NIP. NIP.

  Xxxxxxx, Xxxxxxxx

§738 付則 1 カントリーチャート - FC2

§738 付則 1 カントリーチャート - FC2

www009.web.fc2.com

8 アルメニア xxxx xxxxx xx 9 アルーバ x x x xxxxx x x 10 オーストラリア *3 xxxx 11 オーストリア *3 *4 xxxxxx 12 アゼルバイジャン xxxx xxxxx xx 13バハマxx x xxxxxxx x 14 バーレーン xxxx xxxxx x x 15 バングラデシュ x x x xxxxx x x 16 バルバドス x x x xxxxxxx x 反テロ …

  Xxxxx, Xxxxxx, Xxxx, Xxxxxxx, Xxxx x xxxxxx, X x x xxxxx x x, Xxxx xxxxx x x, X x x xxxxxxx

NAMED DRIVER EXCLUSION ENDORSEMENT …

NAMED DRIVER EXCLUSION ENDORSEMENT

portal.gainscoconnect.com

NAMED DRIVER EXCLUSION ENDORSEMENT Effective: xxxxxxx Nothing herein contained shall be held to alter, vary, waive, or extend any of the terms, conditions, agreements, or limits of

  Drivers, Effective, Named, Endorsement, Exclusion, Xxxxxxx, Driver exclusion endorsement named, Named driver exclusion endorsement effective

SAS DPAN 58 rue Jean Marie Lehn 11100 …

SAS DPAN 58 rue Jean Marie Lehn 11100 …

www.comptoirauto.com

Nos conseils d'installation DA00038 DA00088 DA00089 DA00039 DA00040 DA00069 DA00070 Installation sous capot moteur X Installation sur plancher X XXXX Installation dans portes XXXXXX Installation sur panneaux et parois latérales XXXXXXX Installation dans l'habitacle au niveau du tablier

  Xxxxxxx

平安紙樣本:A 餐 - healthyhkec.org

平安紙樣本:A 餐 - healthyhkec.org

www.healthyhkec.org

本人陳好心(Chan Ho Sum),香港身份證號碼xxxxxxx,住址為 xxxxx,在xxxxxxxx 日簽立遺囑如下: 1. 本人撤銷以前所立的所有遺囑、遺囑修訂附件及遺囑性質的產權處置,並聲 明本遺囑是本人所立的最後遺囑。 2.

  Xxxx, Xxxxxxx, 平安紙樣本 a, 平安紙樣本

ATTO COSTITUTIVO DELL'ORGANIZZAZIONE DI …

ATTO COSTITUTIVO DELL'ORGANIZZAZIONE DI …

www.informazionefiscale.it

Articolo 2) L’Associazione ha sede in Via xxxxxxx n. x in xxxxxx (xx) Essa potrà istituire sedi secondarie ed unità locali per lo svolgimento delle proprie attività in altri luoghi. Articolo 3) L’Associazione è regolata dal D.Lgs. 3 luglio 2017 n. 117, così come modificato dall’art. 3 del

  Xxxxxx, Xxxxxxx

Capability Statement Worksheet - Small Business …

Capability Statement Worksheet - Small Business

www.sba.gov

XXXXXXX and XXXXX by the XXXXX, and is expert in XXXXXX. BUSINESS SUMMARY: The Summary should a paragraph that tells your reader who you are and what you do. If you wish, the paragraph can include a brief history of the business. CAPABILITIES Areas of expertise – types of work you can do for your client. Use short sentences or bullet statements.

  Business, Worksheet, Testament, Small, Capability, Small business, Xxxxxx, Xxxxxxx, Capability statement worksheet

HOW TO INVEST THROUGH WEBSITE

HOW TO INVEST THROUGH WEBSITE

transact.miraeassetmf.co.in

xxxxxxx xxxxxx xxxxxx xx". Please click Here to read the information. > Also note that in order to align the name of Mirae Asset xxxx xxxxxx xxxxxx xx with SEBI circular dated October 6, 2017, the Scheme is being renamed to "Mirae Asset xxxx …

  Xxxxxxx

Sin título-1

Sin título-1

www.fiscalia.gov.co

Bienvenido XXXXXX XXXXXXX XXXXX XXXX Aqui podrá consultar y car-gar toda su información personal . í'ìQUÉ SIGNIFICA CADA ICONO DEL MENú LATERAL DEL SIDCA? Datos En este modulo, visualizará los datos que relac onó env su registro, asimismo,

  Xxxxx, Xxxxxxx, Xxxxx xxxxxxx

TECHNICAL INFORMATIO N Telegram Listing

TECHNICAL INFORMATIO N Telegram Listing

cdn.sickcn.com

LD-XXXxxxx: 192.168.1.10 LMS4000: 192.168.0.1 Subnet mask is 255.255.255.0. IP ports: 2111: CoLa A (fixed) (for LMS4000 fixed CoLa B) 2112: CoLa A (can be switched to CoLa B) 2213: UDP The document does not or only in a few exceptional cases differentiate bet ween indivi - dual device versions or sub product families such as LMS5xx Lite and ...

  Xxxxxxx

Software Manual Template Procedures

Software Manual Template Procedures

images.template.net

XXXXXXX . EPRI Project Manager C. Handy ELECTRIC POWER RESEARCH INSTITUTE 3420 Hillview Avenue, Palo Alto, California 94304-1338 PO Box 10412, Palo Alto, California 94303-0813 USA ... “The ABC software version xx …”) Description . This is one paragraph providing a summary description of the software. Also note if customers

  Manual, Procedures, Software, Template, Xxxxxxx, Software manual template procedures

1015: DBQ Medical Opinion (Complete)

1015: DBQ Medical Opinion (Complete)

vesservices.com

Page 3 of 3 VA Claim Number: XXXXXXX TBI Evaluation conducted on 10/03/2013 Is the current severity of the (claimed condition/diagnosis) greater than the baseline? [] Yes [X] No If yes, was the Veteran’s (claimed condition/diagnosis) at least as likely as …

  Xxxxxxx

ゴム・プラスチック類の耐薬品性一覧表

ゴム・プラスチック類の耐薬品性一覧表

www.marutsu.co.jp

X:大きく影響があるため使用に適さない。 ゴム プラスチック 熱可塑樹脂 塩化ビ ニール樹 脂 ナ イ ロ ン ア ク リ ル 樹 脂 酢酸 100 室温 X X X X X X 酢酸アルミ XXXXXXX X X

  Xxxxxxx, X x x x x x, Xx x xxxxxx

休業支援金・給付金支給申請書 記入見本

休業支援金・給付金支給申請書 記入見本

www.mhlw.go.jp

xxxxxxx xx x xx xx xxxx xxxx xx 東京 0-0 ビル 階 部 担当 花子 項目1〈事業所の名称〉・2〈事業所の 所在地〉に記載する事業所は、対象 となる労働者が実際に就労する拠 点等の情報を記入 …

  Xxxx, Xxxxxxx, Xxxxxxx xx x xx xx xxxx

Document: ReleasedPISAItems Maths - OECD

Document: ReleasedPISAItems Maths - OECD

www.oecd.org

XXXXXXX X X X X X X X X X X n n n n X X X X n n n n X X X X n n n n X X X X n n n n X X X X X X X X X X Question 1: APPLES M136Q01- 01 02 11 12 21 99 Complete the table: n Number of apple trees Number of conifer trees 1 1 8 2 4 3 4 5 APPLES SCORING 1 Complete the table: ...

  Code, Xxxxxxx, X x x x, Xxxxxxx x x x x x x x x x x, X x x x x x x x x x

5080, Sales, Use and Withholding Taxes Monthly/Quarterly ...

5080, Sales, Use and Withholding Taxes Monthly/Quarterly ...

www.michigan.gov

XXXXXXX . 2b. 3. Total prepaid tax from Form 5083, 5085 and/or 5086 (e-file only) 3b. 4. Remaining amount of sales and/or use tax eligible for discount. ... (Tax x .6667 x .0075). The maximum discount is $20,000 for the tax period. • calculate discount using this formula: (Tax x .6667 x .005). The maximum discount is $15,000

  Xxxxxxx

【記入例】年金受給権者 受取機関変更届(兼 年金生活者支 …

【記入例】年金受給権者 受取機関変更届(兼 年金生活者支 …

www.nenkin.go.jp

x x x x x x 記入不要 です xx xx xx xxxxxxx トウキョウ スギナミ 受取機関を銀行等(ゆうちょ 銀行以外)へ変更する場合 「1金融機関」に変更後の受取 先金融機関名・支店名・預金種 別・口座番号を記入してください。 を記入してくださ い。

  Xxxxxxx, X x x x x x

ATTESTATO DI PRESTAZIONE ENERGETICA DEGLI EDIFICI

ATTESTATO DI PRESTAZIONE ENERGETICA DEGLI EDIFICI

www.certificato-energetico.it

E-mail xxxx Telefono xxxx Titolo xx xxxx Ordine/iscrizione xxxxxxx Dichiarazione di indipendenza Il sottoscritto certificatore Arch. Andrea Denza dell'art.3 del DPR 16 aprile 2013, n. 75, al fine di poter svolgere con indipendenza e edificio/impianto DICHIARA l'assenza di conflitto di interessi, tra l'altro espressa attraverso il non ...

  Glides, Attestato, Xxxx, Xxxxxxx, Energetica, Edifici, Xxx xxx, Prestazione, Attestato di prestazione energetica degli edifici

Section 4 - Document Locator Number - IRS tax forms

Section 4 - Document Locator Number - IRS tax forms

www.irs.gov

o Employer Identification Number XX-XXXXXXX (BMF, EPMF) o IRS Adoption Taxpayer Identification Number 9XX-93-XXXX (IMF) Note: A temporary SSN is sometimes assigned by the Campus. The first three digits (900-999) indicate the number is temporary. The 4th and 5th digits are the code of the Campus assigning the number.

  Form, Xxxx, Xxxxxxx, Irs tax forms

APPLICANT/VENDOR DISCLOSURE STATEMENT

APPLICANT/VENDOR DISCLOSURE STATEMENT

www.dds.ca.gov

Enter Vendor’s nine-digit EIN assigned by the IRS in the following format: XX-XXXXXXX. • An EIN is used to identify the accounts of employers and certain others who have no employees. ... Medicaid or the Title XX services program, or those individuals and entities that meet the criteria included in Title 17,

  Testament, Applicants, Disclosures, Vendor, Xxxxxxx, Xxxxxxx xx, Applicant vendor disclosure statement

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