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[DOCX File]Tool 11: Community Resource Guide - Home | Agency for ...
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The second column lists a contact person, their phone number, the hours of operation, and the services provided. Homeless Services . Multi-Service Drop in Center. Contact: Jennifer, Manager (555) 555-8888 ... free medical and dental clinics and day shelter. Has a client services manager and case manager on staff who provide referrals for ...
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Anthem
Jan 01, 2017 · For out-of-state members, call the member’s Home Plan phone number on the back of the member’s ID card. (24 hours) APPEALS Address for First Level Appeal / Retro Review: Anthem Blue Cross and Blue Shield. Attn: Anthem Behavioral Health. P.O. Box 2100. North Haven, CT 06473. Address for First Level Appeal / Retro Review: Anthem Blue Cross ...
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[DOC File]EXAMPLES OF WORDING FOR INFORMED CONSENT FORMS
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[Name, department, university email and telephone number. If investigator is a student, identify and include university information for faculty supervisor.] Key Information: This section is only to be used for federally funded studies and only when the ICF is 2,000 words (about 5 pages) or longer. See guidance at the end of this template.
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[DOC File]Home | U.S. Department of Labor
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The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number.
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[DOC File]Exhibit 5-3: Acceptable Forms of Verification
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For a fee, additional information can be obtained from The Work Number 800-996-7556; First American Registry 800-999-0350; and Verifax 800-969-5100. Fees are valid project expenses. Information does not replace third-party verification. Family composition. None required. None required. Birth certificates. Divorce actions. Drivers’ licenses ...
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[DOCX File]Model Summary Annual Report Notice (Plan Administrators ...
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If you are unable to obtain or examine copies of the regulated financial institution statements or evidence of the fidelity bond, you may contact the regional office of the U.S. Department of Labor's Employee Benefits Security Administration (EBSA) for assistance by calling toll-free 1.866.444.EBSA (3272).
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[DOCX File]ADP Registration for Employees/Associates
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During registration, if you provided a mobile phone number that is not shared with other users in your organization, look out for a text message from ADP. Reply with the code. Note: In some countries, your activation process will differ; so, follow the instructions in the text message to activate your mobile number…
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[DOC File]CONTRACTORS IN THE WORKPLACE - U.S. Army
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In addition, contractors should identify themselves as a contractor employee when answering the phone and their voicemail should likewise indicate their special status. All these safeguards are necessary to avoid potential conflicts of interest and other problems caused by inadvertent disclosure of proprietary or other sensitive information to ...
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[DOC File]SOM - State of Michigan
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4. Daytime Phone Number-- 5a. Social Security Number (Voluntary) 5b. Email Address (Voluntary) 6a. Driver’s License Number or Personal Identification Number. 6b. Driver’s License or Personal Identification State of Issuance. 7a. Primary Residence Address. 7b. Primary Residence City. 7c. Primary Residence ZIP Code. 8a. Mailing Address (If ...
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[DOCX File]REQUEST FOR INFORMATION (template for 2
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Name, mailing address, overnight delivery address (if different from mailing address), phone number, fax number, and e-mail of designated point of contact. 4.3.2. Recommended contracting strategy. 4.3.3. Either 1) copies of executed non-disclosure agreements (NDAs) with the contractors supporting SPAWAR and SPAWAR supported PEOs and DRPMs in ...
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Get a free phone number