List of current social topics

    • [PDF File]CHAMPVA - U.S. Department of Veterans Affairs

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      Make a list of any prescription or over-the-counter (OTC) medications you take on a regular basis, as well as the dosages. Make a note of any symptoms you may be having, including duration, intensity and what, if anything, relieves the symptoms. Be sure to also make a list of any questions you may

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    • [PDF File]AUTHORIZATION, AGREEMENT B. Request Status …

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      Information Regarding Disclosure of your Social Security Number (SSN) Under Public Law 93-579, Section 7(b) ─ Solicitation of SSNs by the Office of Personnel Management (OPM) is authorized under provisions of the Executive Order 9397, dated November 22, 1943. Your SSN will be used primarily to give you recognition for

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    • [PDF File]IRA Required Minimum Distribution Worksheet

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      Retirement Topics – Required Minimum Distributions . 1. Generally, your marital status is determined as of January 1. of each year. If your spouse is the beneficiary of your IRA on January 1, he or she remains a beneficiary only for purposes of calculating the

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    • [PDF File]Power of Attorney for Health Care

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      chaplain or social worker. A witness cannot be an employee of an inpatient health care facility in which you are a patient, unless the employee is a chaplain or social worker. A witness cannot be your health care agent nor have a claim on any portion of your estate. Valid witnesses acting in good faith are immune from civil or criminal liability.

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    • [PDF File]Form 1040X Amended U.S. Individual Income Tax Return

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      Your social security number . If a joint return, spouse’s first name and initial. Last name Spouse’s social security number . Current home address (number and street). If you have a P.O. box, see instructions. Apt. no. Your phone numberCity, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below.

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    • [DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy

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      periods of leave i certify that i have sufficient funds to cover the cost of round trip travel. i understand that should any portion of this leave, if approved, result in my taking more leave than i can earn on my current un-extended enlistment or current active duty obligation, my pay will …

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    • [PDF File]Section B. Acceptable Sources of Borrower Funds Overview

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      HUD 4155.1 Chapter 5, Section B 5-B-1 Section B. Acceptable Sources of Borrower Funds Overview In This Section This section contains the topics listed in the table below. Topic Topic Name See Page 1 General Information on Acceptable Sources of

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    • [PDF File]Adverse Childhood Experience (ACE) Questionnaire Finding ...

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      Adverse Childhood Experience (ACE) Questionnaire Finding your ACE Score ra hbr 10 24 06 While you were growing up, during your first 18 years of life: 1. Did a parent or other adult in the household often … Swear at you, insult you, put you down, or humiliate you?

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    • [PDF File]Complying With Medical Record Documentation Requirements

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      nationally-consistent education on topics of interest to health care professionals. This fact sheet describes common CERT Program errors related to medical record documentation. It is designed to help providers understand how to provide accurate and supportive medical record documentation. Visit the Centers for Medicare & Medicaid Services (CMS ...

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    • [PDF File]DEVELOPMENTAL COUNSELING FORM

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      Plan of Action (Outlines actions that the subordinate will do after the counseling session to reach the agreed upon goal(s). The actions must be

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