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[PDF File]Form W-9 (Rev. October 2018)
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Form W-9 (Rev. 10-2018) Page . 2 By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a
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[PDF File]Request for Social Security Earnings Information
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Government. A complete list of routine uses for credit card information is available in our System of Records Notice entitled, the Financial Transactions of SSA Accounting and Finance Offices (60-0231). The notice, additional information regarding this form, routine uses of information, and our programs and systems is available on-line at
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[PDF File]Patient Health Questionnaire (PHQ-9)
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PATIENT HEALTH QUESTIONNAIRE (PHQ-9) NAME: DATE: Over the last 2 weeks, how often have you been bothered by any of the following problems? Not at all Several days More than half the days Nearly every day (use " ü " to indicate your answer) 1. Little interest or pleasure in doing things 0 1 2 3
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[PDF File]2018 Form 5329
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Additional Tax on Certain Distributions From Education Accounts and ABLE Accounts. Complete this part if you included an amount in income, on Schedule 1 (Form 1040), line 21, or Form 1040NR, line 21, from a Coverdell education savings account (ESA), a qualified tuition program (QTP), or an ABLE account. 5 .
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[PDF File]2019 Instructions for Form 1042-S
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FIRE System. See the instructions for Electronic Reporting, later. Also, if applicable, the option to file Form 1042-S by paper is still available. Foreign tax identification number and date of birth. A financial institution that files a Form 1042-S with respect to a payment on an obligation that it maintains at its U.S. office or U.S.
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[PDF File]Request for Leave or Approved Absence
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Request for Leave or Approved Absence. 1. Name (Last, first, middle) 2. Employee or Social Security Number (Enter only the last 4 digits of the Social Security Number (SSN))
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[PDF File]2018 Form 8962
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Total premium tax credit. Enter the amount from line 11(e) or add lines 12(e) through 23(e) and enter the total here
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[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
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[PDF File]VAMC SLUMS Examination - School of Medicine
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SH Tariq, N Tumosa, JT Chibnall, HM Perry III, and JE Morley. The Saint Louis University Mental Status (SLUMS) Examination for Detecting Mild Cognitive Impairment and Dementia is more sensitive than the Mini-Mental Status Examination (MMSE) - A pilot study. J am Geriatri Psych ( in press). 2 3 Questions about this assessment tool? E-mail aging ...
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[PDF File]2018 Publication 946 - Internal Revenue Service
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required to use the alternative depreciation system for certain property to figure depreciation under MACRS for tax years beginning after 2017. Recovery period for residential rental property. For the property placed in service after 2017, the alternative depreciation system (ADS) recovery period for residential
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Education system meaning