771 Form Details

Form Dd 771 is a Stock Purchase Agreement used between two or more parties to agree on the purchase and sale of stock. The form includes information on the seller, buyer, shares being sold, and the price per share. This document is often used in transactions between family members, friends, or business partners. It's important to understand what this form entails before signing it, as it can be legally binding. By understanding the contents of Form Dd 771 and any associated risks, you can make an informed decision about whether or not to sign it.

This page provides information about form dd 771. There, you'll obtain the details about the form you intend to fill in, such as the estimated time for you to complete it and also other details.

QuestionAnswer
Form NameForm Dd 771
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdd 771 form, dd 771 form printable, form 771, dd 771

Form Preview Example

(THIS FORM IS SUBJECT TO THE

PRIVACY ACT OF 1974 -

Use DD Form 2005.)

EYEWEAR

PRESCRIPTION

DATE

ACCOUNT NUMBER

ORDER NUMBER

TO: (Lab)

FROM:

NAME (Last, First)

ADDRESS/UNIT

ADDRESS CONTINUED

CITY, STATE, ZIP

SSN

GRADE

 

PHONE

 

 

 

 

 

 

 

 

 

 

SHIP TO:

 

 

 

 

CLINIC

 

PATIENT

 

 

 

 

 

 

 

 

AD

RES

NG

RET

OTHER*

A

N

AF

MC

CG

PHS

OTHER*

FRAME

 

EYE

 

BRIDGE

 

TEMPLE

 

COLOR

 

 

 

DIST

NEAR

LENS

 

TINT

 

MATERIAL

 

PAIR

CASE

PD

 

 

 

 

 

 

 

 

 

 

 

 

SPHERE

CYLINDER

AXIS

DECENTER

 

H PRISM

H BASE

V PRISM

V BASE

R

L

MULTIVISION

NEAR ADD

SEG HT

TOTAL DECENTER

R

L

LAB USE

 

 

PRIORITY

TECH INITIALS

 

 

SPECIAL COMMENTS/JUSTIFICATION (*Use this space to specify blocks marked "Other.")

PRESCRIBING OFFICER/AUTHORITY

SIGNATURE

DISTRIBUTION:

ORIGINAL - Retained by Lab.

COPY 1 - Returned with eyewear.

COPY 2 - Entered in health record.

DD FORM 771, JUL 96

PREVIOUS EDITION IS OBSOLETE.

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