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| 76. Assignment of Security Interest Form 77. Assignment of Trademark Form 78. Assignment of Trademark Form II 79. Assignment of a Claim for Damages Form 80. Assignment Form 81. Authorization to Direct Bill for Corporate Guest 82. Authorization to Participate in Medical Plan 84. Bid for the Purchase of Real Property [Probate] Form 85. Bill of Sale [with Warranty of Title] Form 87. Business Credit Application Form 88. Certificate of Abandonment of Fictious Business Name Form 89. Certificate of Satisfaction of Lien 90. Change of Address Awaiting Refund 91. Charge Account Credit Limit Raise Notification 92. Charge Account Terms and Conditions Form 93. Charge Back Application of Discount on Delayed Shipment 94. Collateral Decision, Request for Preparation of Loan Documents 95. Commendation and Refusal of Requests for Funds 96. Commendation on Good Suggestion 97. Commendation 98. Commitment Form [Advertising] 100. Company Credit Approval Letter
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AUTHORIZATION TO PARTICIPATE As an employee of [name of firm] , I do (do not) wish to participate in the Company's Medical Plan. [name of firm] is hereby authorized to make the necessary deductions from my earnings or any disability benefit paid to me by the company, for the amount specified in the Group Insurance Schedule. It is my understanding that I will be eligible to participate in the Company Medical Plan as of [date] and that the monthly deductions referred to herein will begin on [date] I further understand that the acceptance of my application for participation in the Company Medical Plan is contingent upon my ability to meet the medical requirements determined by [name of insurance company] Date:_________________
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