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    • [PDF File]VERIFICATION OF VEHICLE IDENTIFICATION NUMBER

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      ANY ALTERATION OR ERASURE MAY VOID THIS DOCUMENT Type of Vehicle Passenger SUV Truck Tractor Bus Trailer Motor Home Special Mobile Machinery Manufactured Home Motorcycle Off-Highway Vehicle VEHICLE INFORMATION Vehicle Identification Number (VIN) Year Make Body Model Width Length Color CWT GVWR Print Fuel Type License Plate Number State ...

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    • [PDF File]TC-721, Utah Sales Tax Exemption Certificate

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      *Purchaser must provide sales tax license number in the header on page 1. NOTE TO PURCHASER: You must notify the seller of cancellation, modification, or limitation of the exemption you have claimed. Questions? Email taxmaster@utah.gov, or call 801-297-2200 or 1-800-662-4335. * Direct Mail I certify I will report and pay the sales tax for direct mail purchases

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    • [PDF File]POWER OF ATTORNEY FOR A MOTOR VEHICLE, MOBILE …

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      name, in my/our behalf. My attorney-in-fact can also do all things necessary to the application or any other related instrument and to bind me/us in as sufficient a manner as I/we myself/ourselves could do, were I/we personally present and signing the same.

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    • [PDF File]Mini-Mental State Examination

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      Mini-Mental State Examination (MMSE) Patient’s Name: Date: Instructions: Ask the questions in the order listed. Score one point for each correct response within each question or activity. Maximum Score Patient’s Score Questions 5 “What is the year? Season? Date? Day of the week? Month?” 5 “Where are we now: State? County?

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    • [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 . . . . . .

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    • [PDF File]Form 1040X Amended U.S. Individual Income Tax Return

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      Attach any supporting documents and new or changed forms and schedules. Remember to keep a copy of this form for your records. Under penalties of perjury, I declare that I have filed an original return and that I have examined this amended return, including accompanying schedules and

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    • [DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal

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      Covers children for whom there is a state-only AAP agreement between any state other than California and adoptive parents. 4E Full No HPE (Title XIX). Covers former foster care children age 26 or younger with no income screening. 4F Full No Kinship Guardianship Assistance Payment (Kin-GAP) Cash Assistance. ... Aid Codes Master Chart (aid codes) ...

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    • [PDF File]www.dmv.pa.gov APPLICATION FOR DUPLICATE CERTIFICATE …

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      TO BEFORE ME: MONTH DAY YEAR S T A M p I/We state that I/we have read and signed this application after its completion, and I/we swear or affirm that the statements made herein are true and correct, and that any statement made on or pursuant to this …

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    • Nutritional Information & Facts Download | Zaxby's

      Zaxby’s suppliers may use ingredients in their manufacturing facilities where trace amounts of allergens could come in contact with Zaxby’s ingredients, or any product formula could be changed without prior notice to Zaxby’s. We encourage anyone with food

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    • [PDF File]FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR …

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      8 motor vehicle identification number verification this section requires a physical inspection and a verification of the vehicle identification number (vin) (or the motor number for motor vehicles manufactured prior to 1955) of the motor vehicle described on this form by a licensed dealer, florida notary public, police officer, or florida division of motor vehicles

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