Create a business email address
[PDF File]APPLICATION FOR ENROLLMENT IN MEDICARE PART B …
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address. 6. Phone Number: Write your 10-digit phone number, including area code. 7. Written Signature: Sign your name in this section in the same way you would sign it for any other official document. Do not print. If you’re unable to sign, you may mark an “X” in this field. In …
[PDF File]CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) …
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description of operations / locations / vehicles (attach acord 101, additional remarks schedule, if more space is required) insr ltr type of insurance policy number policy eff (mm/dd/yyyy) policy exp (mm/dd/yyyy) limits wc statu-tory limits oth-er e.l. each accident e.l. disease - ea employee e.l. disease - policy limit $ $ $ any proprietor ...
[PDF File]Form ST-124:(12/15):Certificate of Capital Improvement:ST124
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Street address (where the work is to be performed) City State ZIP code I certify that: • I am the (mark an X in one) owner tenant of the real property identified on this form; and • the work described above will result in a capital improvement to the real property as outlined in the instructions of this form; and
[PDF File]Form 1957 - Bill of Sale or Even-Trade Bill of Sale
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The Bill of Sale or Even-Trade Bill of Sale must be notarized when showing proof of ownership on major component parts of a rebuilt vehicle or when specifically requested to be notarized by the Department of Revenue. Purchaser(s) Names(s) (typed or printed) Seller(s) Name(s) (typed or printed) Address Address
[PDF File]FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR …
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Mobile Home Physical Address (if applicable) Check if in a mobile home rental park with 10 or more lots. \ City State Zip Mail To Customer Name (If different From Above Owner) Mail To Customer’s Email Address Date of Birth Sex FL Driver License or FEID/Suffix # Mail To Customer Address (If different From Above Mailing Address) Zip City State
[PDF File]Form 4506-T (Rev. 6-2019)
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For a business address, file Form 8822-B, Change of Address or Responsible Party — Business. Line 5b. Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript. The customer file number : should not: contain an SSN. Completion of this line is not required.
[PDF File]Request for Leave or Approved Absence
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Public Law 104-134 (April 26, 1996) requires that any person doing business with the Federal Government furnish a social security number or tax identification number. This is an amendment to Title 31, Section 7701. Furnishing the social security number, as well as other data, is voluntary, but failure to do so may
[PDF File]Form W-9 (Rev. October 2018)
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that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the
[PDF File]Form I-693, Report of Medical Examination and Vaccination ...
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Interpreter's Business or Organization Name (if any) Interpreter's Full Name Applicant's Contact Information. 3. Applicant's Daytime Telephone Number. 4. Applicant's Mobile Telephone Number (if any) 5. Applicant's Email Address (if any) Form I-693 07/15/19. Page 3 of 14 Family Name (Last Name)
[PDF File]TEXAS WORKERS’ COMPENSATION WORK STATUS REPORT
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email, or similar method) at the time of the examination • insurance carrier . electronic transmission within 2 working days of the examination • employer . electronic transmission unless recipient has not provided a fax numberor email address; then by personal delivery or mail • after receiving a set of functional job descriptions
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