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[PDF File]DR 2395 (04/02/15) COLORADO DEPARTMENT OF REVENUE Application ...
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After obtaining a registration, you will be required to sign an affirmation clause indicating compliance with insurance require ments. Unless a person waives his or her confidentiality, the information contained in the person’s motor vehicle record shall not be used for any purpose other than a
[PDF File]Schedule B (Form 941)
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When you file this form with Form 941 or Form 941-SS, don't change your tax liability by adjustments reported on any Forms 941-X or 944-X. You must fill out this form and attach it to Form 941 or Form 941-SS if you're a semiweekly schedule depositor or became one because your accumulated tax liability on any day was $100,000 or more.
[PDF File]Health Benefits Election Form
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If you are separated but not divorced, you are still married. Item 7. If you have Medicare, check which Parts you have, including prescription drug coverage under Medicare Part D. Item 8. If you have Medicare, enter your Medicare Claim Number. This number is on your Medicare Card. Item 9. If you are covered by other health insurance, either in your
[PDF File]PISTOL SALES RECORD MICHIGAN STATE POLICE PISTOL SALES RECORD
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The purchaser shall receive two copies of the form and the seller may retain one copy. Within ten days of purchase or acquisition, the purchaser must submit the registry copy to the city, village, or
[PDF File]The Mood Disorder Questionnaire (MDQ) - Overview
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The Mood Disorder Questionnaire (MDQ) - Overview The Mood Disorder Questionnaire (MDQ) was developed by a team of psychiatrists, researchers and consumer advocates to address the need for timely and accurate evaluation
[PDF File]Patient Health Questionnaire (PHQ-9)
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2. Add up 3s by column. For every 3: Several days = 1 More than half the days = 2 Nearly every day = 3 3. Add together column scores to get a TOTAL score. 4. Refer to the accompanying PHQ-9 Scoring Box to interpret the TOTAL score. 5. Results may be included in patient files to assist you in setting up a treatment goal, determining degree of
[PDF File]Funding Fee Tables
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3.3% * 3.3% * *The higher subsequent use fee does not apply to these types of loans if the Veteran's only prior use of entitlement was for a manufactured home loan.
[PDF File]VAMC SLUMS Examination - Saint Louis University
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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.
[PDF File]8821 Tax Information Authorization OMB No. 1545-1165
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If the tax information authorization is for a specific use not recorded on CAF, check this box. See the instructions. If you check this box, skip lines 5 and 6 . . . . . .
[PDF File]POS-010 Proof of Service of Summons
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At the time of service I was at least 18 years of age and not a party to this action. Form Adopted for Mandatory Use PROOF OF SERVICE OF SUMMONS Judicial Council of California
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