New york take 5
[PDF File]Form 149 - Sales and Use Tax Exemption Certificate
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149 Sales and Use Tax Exemption Certificate. Form 149 (Revised 11-2018) ... This exemption includes machinery and equipment used to establish new or to replace existing material recovery processing plants. See Sections 144.030.2(5) and (32), RSMo, for a definition of, and exemptions for, material recovery processing. ...
[PDF File]Application for Social Security Card
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Form SS-5 (08-2011) ef (08-2011) Destroy Prior Editions. Page 1. Application for a Social Security Card. Applying for a Social Security Card is . free! USE THIS APPLICATION TO: Apply for …
[PDF File]8821 Tax Information Authorization OMB No. 1545-1165
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Tax Information Authorization ... Check if new: Address . Telephone No. Fax No. 3 Tax Information. Appointee is authorized to inspect and/or receive confidential tax information for the type of tax, forms, periods, and specific matters you list below. See the line 3 instructions.
[PDF File]Request for Social Security Earnings Information
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display a valid Office of Management and Budget control number. We estimate that it will take about 11 minutes to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401.
[PDF File]Form W-9 (Rev. October 2018)
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5. Address (number, street, and apt. or suite no.) See instructions. 6. City, state, and ZIP code. Requester’s name and address (optional) 7. List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding.
[PDF File]Patient Health Questionnaire (PHQ-9)
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- if there are at least 5 3s in the shaded section (one of which corresponds to Question #1 or #2) Consider Other Depressive Disorder - if there are 2-4 3s in the shaded section (one of which corresponds to Question #1 or #2) Note: Since the questionnaire relies on patient self-report, all responses should be verified by the clinician,
Standard Form 1199A, Direct Deposit Sign-up Form
Then take or checks. (See the sample check on the back of this form.) This mail this form to the financial institution. The financial institution will information is also stated on beneficiary/annuitant award letters and verify the information in Sections 1 and 2, and will complete Section 3. other documents from the Government agency.
[PDF File]Removal and/or Inspection of a Motor Vehicle at a VSF
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5. completing Section Five. (Note: This section provides the authorization to inspect or remove the vehicle; may be different from the person named in Section 3) This document affects your legal rights and may give others access to your motor vehicle. If you do not understand this document or …
[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]VAMC SLUMS Examination - School of Medicine
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5. You have $100 and you go to the store and buy a dozen apples for $3 and a tricycle for $20. How much did you spend? How much do you have left? 6. Please name as many animals as you can in one minute. 0-4 animals 5-9 animals 10-14 animals 15+ animals 7. What were the five objects I asked you to remember? 1 point for each one correct. 8.
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