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[DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal
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The Aid Codes Master Chart was developed for use in conjunction with the Medi-Cal Automated Eligibility Verification System (AEVS). Providers must submit …
[PDF File]BILL OF SALE
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BILL OF SALE VEHICLE INFORMATION Make: _____ Model: _____ Year: _____ Style: _____ Color: _____ VIN# _____
[PDF File]Estimated Earnings During Military Service
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United States Office of Personnel Management Retirement Operations Center Boyers, Pennsylvania 16017 Estimated Earnings During Military Service
[DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
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navcompt form 3065 (3pt) (rev. 2-83) 1. date of request. 2. for . admin. use only. approval of this leave is . not valid . without control no,
[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) Select the appropriate box for the type of exemption to be claimed and complete any additional information requested. ... • Purchaser’s Home State: Provide the state in which purchaser is located and registered.
[PDF File]Form W-9 (Rev. October 2018)
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• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.
[PDF File]STATE OF TENNESSEE DEPARTMENT OF LABOR AND …
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DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT DIVISION OF EMPLOYMENT SECURITY (mm/dd/yy) (mm/dd/yy) INSTRUCTIONS SEPARATION NOTICES Rule 0800-09-01-.02 of the Rules and Regulations of the Tennessee Employment Security Law, requires all employers
[PDF File]Form 941 for 2019: Employer’s QUARTERLY Federal Tax Return
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Form 941-V, Payment Voucher. Purpose of Form. Complete Form 941-V if you're making a payment with Form 941. We will use the completed voucher to credit your payment more promptly and accurately, and to improve our service to you. Making Payments With Form 941. To avoid a penalty, make your payment with Form 941 . only if:
[PDF File]Consent for Release of Information
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If you want us to release a minor child's medical records, do not use this form. Instead, contact your local Social Security office. I am the individual, to whom the requested information or record applies, or the parent or legal guardian of a minor, or the
[PDF File]THIS FORM SHOULD NOT BE FILED WITH THE COURT FL-142 ...
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11. STOCKS, BONDS, SECURED NOTES, MUTUAL FUNDS (Give certificate number and attach copy of the certificate or copy of latest statement.) 12. RETIREMENT AND PENSIONS (Attach copy of latest summary plan documents and latest benefit statement.)
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