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[PDF File]Designation Notice (Family and Medical Leave Act)
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Designation Notice (Family and Medical Leave Act) Wage and Hour Division. U.S. Department of Labor . OMB Control Number: 1235-0003. Expires: 8/31/2021. Leave covered under the Family and Medical Leave Act (FMLA) must be designated as FMLA-protected and the employer must inform the employee of the
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[PDF File]AUTHORIZATION, AGREEMENT B. Request Status Resubmission ...
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a. Non-supervisory. b. Managerc. Supervisory. d. Executive9. Work Email Address 14. Training Accreditation Indicator Check below) (Yes. NoIf yes, please describe below 13. Education Level (click link to view codes or go to page 7) 14. Pay Plan 15. Series 16. Grade 17. Step 1a. Name and Mailing Address of Training Vendor (No., Street, City ...
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[PDF File]SUPERIOR COURT OF CALIFORNIA, COUNTY OF
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(a) Interrogatories are written questions prepared by a party to an action that are sent to any other party in the action to be answered under oath. The interrogatories below are form interrogatories approved for use in civil cases. (b) For time limitations, requirements for service on other
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[PDF File]Indiana Parenting Time Guidelines
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Indiana Parenting Time Guidelines and should be specific in their written agreement. 3. Presumption. There is a presumption that the Indiana Parenting Time Guidelines are applicable in all cases. Deviations from these Guidelines by either the parties or the cou rt that result in parenting time less than the minimum
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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 Pertaining to Military Records, SF 180 (11-15)
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INSTRUCTION AND INFORMATION SHEET FOR SF 180, REQUEST PERTAINING TO MILITARY RECORDS 1. General Information. The Standard Form 180, Request Pertaining to Military Records (SF180) is used to request information from military records. Certain identifying information is necessary to determine the location of an individual's record of military service.
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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 Instructions for Form 8863
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qualified education expenses paid under a formal billing arrangement, or is enrolled only in courses for which no academic credit is awarded). If a student’s educational institution isn't required to provide a Form 1098-T to the student, you may
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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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[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]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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Non formal education pdf