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[PDF File]Form 941 for 2019: Employer’s QUARTERLY Federal Tax Return
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quarter for which the payment is made. Darken only one circle. Box 4—Name and address. Enter your name and address as shown on Form 941. • Enclose your check or money order made payable to “United States Treasury.” Be sure to enter your EIN, “Form 941,” and the tax period (“1st Quarter 2019,”

[PDF File]Medical Travel Refund Request U.S. Department of Labor
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benefits you have used to a hospital or doctor. Additional disclosures are made through routine uses for information contained in systems of records. See Department of Labor systems DOL/GOVT-1, DOL/ESA-6 and DOL/ESA-49 published in the Federal Register, Vol. 67, page 16816, Mon. April 8, 2002, or as updated and republished.

[PDF File]FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES ...
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if checked, the following certifications are made by the applicant: i certify that this motor vehicle, mobile home or vessel was repossessed upon default in the terms of the lien instrument and is now in my possession. (vessel) a photocopy of the lien instrument for the vessel is required and attached. i am requesting that an original

[PDF File]Application for Social Security Card
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Evidence of Age In general, you must provide your birth certificate. In some situations, we may accept another document that shows your age. Some of the other documents we may accept are:

[PDF File]Vaccine Information Statement: Recombinant Zoster (Shingles ...
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You can’t catch shingles from another person. However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles. A shingles rash usually appears on one side of the face or body and heals within 2 to 4 weeks. Its main symptom is pain, which can be severe. Other symptoms can include

[PDF File]Property Supplement
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O 36 months (or 60 months if the transfer was made to or from a trust or agreement for holding money or property for the benefit of someone) if you are applying for Medi-Cal; or O 12 months if you are currently receiving Medi-Cal? If yes, please explain in the “Additional Information” section at the end of this form and attach verifications.

[PDF File]AUTHORIZATION, AGREEMENT B. Request Status Resubmission ...
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another Federal agency or other organization in any branch of the Government before completing the period of service agreed, I will give my organization written notice of at least ten working days during which time a determination concerning reimbursement will be made. If I fail to give this advance notice, I AGREE to pay

[PDF File]Form W-9 (Rev. October 2018)
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nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper

[PDF File]Form I-693, Report of Medical Examination and Vaccination Record
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of this Form I-693, after having made every reasonable effort to verify that the person whom I examined is in fact the person identified in Part 1.; I performed the examination in accordance with the Centers for Disease Control and Prevention's (CDC) Technical Instructions, as well as all supplemental information or updates; and

[PDF File]APPLICATION FOR CERTIFICATE OF TITLE AND REGISTRATION
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The information, including Social Security Number, is requested in accordance with Virginia Code §§46.2-623 and 46.2-629. Any person who refuses to supply the required information will be denied a certificate of title and/or registration.

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