Data available for use
[PDF File]U.S. Department of Labor PAYROLL Wage and Hour Division ...
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Rev. Dec. 2008 While completion of Form WH-347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R. §§ 3.3, 5.5(a).
[PDF File]AUTHORIZATION FOR DISCLOSURE OF MEDICAL OR DENTAL …
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for authorization to disclose information from records of an alcohol or drug abuse treatment program. In addition, any use as an authorization to use or disclose psychotherapy notes may not be combined with another authorization except one to use or disclose psychotherapy notes. PRIVACY ACT STATEMENT SECTION I - PATIENT DATA 1.
[PDF File]Form SSA-89 (02-2018) Discontinue Previous Editions Page 1 ...
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Collection and Use of Personal Information. Form . SSA-89 (02-2018) Page 2 of 2. Sections 205(a) and 1106 of the Social Security Act, as amended, allow us to collect this information. Furnishing us this information is voluntary. However, failing to provide all or part of the information may
[PDF File]TINETTI BALANCE ASSESSMENT TOOL
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TINETTI BALANCE ASSESSMENT TOOL GAIT SECTION Patient stands with therapist, walks across room (+/- aids), first at usual pace, then at rapid pace. Risk Indicators: Tinetti Tool Score Risk of Falls ≤18 High 19-23 Moderate ≥24 Low Date Indication of gait (Immediately after told to ‘go’.) Any hesitancy or multiple attempts = 0 No hesitancy = 1
[PDF File]APPLICATION FOR 10-POINT VETERAN PREFERENCE (TO BE …
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gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to OPM Forms Officer, U.S. Office of Personnel Management, Washington, D.C. 20415; The OMB Number ...
[PDF File]Request for Social Security Earnings Information
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We rarely use the information in your earnings record for any purpose other than for determining your entitlement to Social Security benefits. However, we may use it for the administration and integrity of Social Security programs. We may also disclose information to another person or to another agency in accordance with approved routine uses ...
[PDF File]Schedule B (Form 941)
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Use this schedule to show your TAX LIABILITY for the quarter; don't use it to show your deposits. When you file this form with Form 941 or Form 941-SS, don't change your tax liability by adjustments reported on any Forms 941-X or 944-X. You must fill out this form and attach it to
[PDF File]Builder's Certification U.S. Department of Housing OMB A ...
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Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
[PDF File]Request for Leave or Approved Absence
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The primary use of this information is by management and your payroll office to approve and record your use of leave. Additional disclosures of the information may be: to the Department of Labor when processing a claim for ... Furnishing the social security number, as well as other data, is voluntary, but failure to do so may delay or prevent ...
[PDF File]Form 941 for 2019: Employer’s QUARTERLY Federal Tax Return
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Form 941-V, Payment Voucher. Purpose of Form. Complete Form 941-V if you're making a payment with Form 941. We will use the completed voucher to credit your payment more promptly and accurately, and to improve our service to you. Making Payments With Form 941. To avoid a penalty, make your payment with Form 941 . only if:
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