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[DOC File]Exhibit 5-3: Acceptable Forms of Verification
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Telephone or in-person contact with income source, documented in file by the owner. NOTE: For all oral verification, file documentation must include facts, time and date of contact, and name and title of third party. Current or recent check stubs with date, amount, and check number recorded by the owner.
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[DOC File]DRUG TESTING AUTHORIZATION & RELEASE
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(COMPANY NAME) DRUG TESTING AUTHORIZATION & CONSENT FORM. I, the undersigned, hereby knowingly and voluntarily authorize and consent to the collection and testing of specimens of my urine by a collection site and laboratory to be designated by Company or its designated agent, Employment Screening Services, Inc., for the purpose of drug testing.
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[DOC File]COMPETENCY CHECKLIST (SAMPLE)
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Method of Evaluation: DO-Direct Observation VR-Verbal Response WE-Written Exam OT-Other Emergency Code Standardization Process Method of Evaluation Initials Comments Patient Safety: Access to emergency code policy and procedure. VR Definitions of each emergency code. WE How to call each emergency code.
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CREDIT CARD AUTHORIZATION FORM
Authorization for Credit Card Use. PRINT AND COMPLETE THIS AUTHORIZATION AND RETURN. All information will remain confidential Name on Card: _____ Billing Address: _____
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[DOCX File]PA - eMarketplace
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The PA Direct File application allows taxpayers to file their PA-40 and corresponding schedules and worksheets with the department for free. It was developed and is currently supported with the assistance of a vendor. The online application accepts original and …
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[DOC File]ALGEBRA 2 X
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Direct. Inverse. Questions from HW: 2) If y varies directly as x, find an equation when y = 6 and x = 3. 9) If y varies inversely as x, find an equation when y = 2 and x = 7. 13) Determine whether each data set represents a direct variation, an inverse variation or neither. x 2 5 9 y 3 6 4
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[DOC File]Individual Narcotic Count Sheet
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Individual Narcotic Count Sheet DHS 4570 revision 7/2014 Client: Debbie Aljets SACU
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[DOT File]Personal Care Assistant Daily Encounter Log
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3 Direct Assisting the student to ambulate, position and transfer. 4 Direct Range of motion and other exercises. 5 Direct Activities of daily living such as eating, grooming, bathing, toileting, etc. 6 Direct Monitoring the incidence and prevalence of designated health problems or medical conditions, e.g. seizure precautions or extreme lethargy.
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[DOC File]PENNSYLVANIA GENERAL DURABLE POWER OF ATTORNEY
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To have free access at any time or times to any safe deposit box or vault to which I might have access. ... or other governmental programs, or military service. To prepare, sign and file any claim or application for Social Security, unemployment or military service benefits; sue for, settle or abandon any claims to any benefit or assistance ...
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[DOCX File]I.History of the Proceeding
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Before the Pennsylvania Public Utility Commission (Commission) for consideration and disposition are the Exceptions of Pennsylvania-American Water Company (PAWC or the Company), filed on June 4, 2018, to the Recommended Decision (R.D.) of Administrative Law Judge (ALJ) Elizabeth H. Barnes, issued on May 15, 2018, in the above-captioned proceeding.
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Free pa direct file