The dallas group of america

    • [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


    • [PDF File]Physician's Order for Personal Care/Consumer Directed ...

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      PHYSICIAN’S ORDER FOR PERSONAL CARE/CONSUMER DIRECTED PERSONAL ASSISTANCE SERVICES . INSTRUCTIONS . COMPLETE ALL ITEMS. (Attach additional sheets, if necessary). INCOMPLETE FORMS WILL BE RETURNED TO THE PHYSICIAN. INCOMPLETE OR MISSING INFORMATION MAY DELAY SERVICES TO THIS PATIENT. 1. Patient Identifying Information • Patient Name.


    • [PDF File]DIRECTV General Market Channel Lineups

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      Channel lineups effective as of 1/28/16. Programming, pricing and offers are subject to change and may vary. In certain markets, a Regional Sports fee of up to $6.39/mo. will be assessed with CHOICE Package and above.


    • [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]FMCSA Medical Examiner Handbook

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      "The mission of the Office of Medical Programs is to promote the safety of America's roadways through the promulgation and implementation of medical regulations, guidelines and policies that ensure commercial motor vehicle drivers engaged in interstate commerce are physically qualified to do so." Page 8 of 260 .


    • [PDF File]ACCIDENT CLAIM FORM - Aflac

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      Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. Aflac is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands.


    • [PDF File]01-339 Sales and Use Tax Resale Certificate / Exemption ...

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      I understand that it is a criminal offense to give an exemption certificate to the seller for taxable items that I know, at thetime of purchase, will be used in a mannerother than that expressed in this certificate, and depending on the amount of tax evaded, the offense may range from a Class C misdemeanor to a felony of the second degree.


    • [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 an inquiry to AEVS to verify a recipient’s eligibility for


    • [PDF File]Return of Organization Exempt From Income Tax 2018

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      Form 990 Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)


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