Baltimore city government
[PDF File]POWER OF ATTORNEY FOR A MOTOR VEHICLE, MOBILE …
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(Co-Owner’s Address) (City) (State) (Zip) This non-secure power of attorney form may be used when an individual or entity appointed as the attorney in fact will be completing the odometer disclosure statement as the buyer only or the seller only. However, this form cannot be
[PDF File]Request for Social Security Earnings Information
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Government Accountability Office and Department of Veterans' Affairs); 3. To make determinations for eligibility in similar health and income maintenance programs at the Federal, ... City ZIP Code 4. I am the individual to whom the record pertains (or a person authorized to sign on behalf of that individual). I ... Request for Social Security ...
[PDF File]USDA Rural Development
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hb - 1 - 3555, appendix 5 guaranteed housing program income limits state:alabama ----- a j u s t e d i n c o m e l i m i t s -----p r o g r a m 1 person 2 person 3 person 4 …
[PDF File]Form W-4V (Rev. February 2018)
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Voluntary Withholding Request (For unemployment compensation and certain Federal Government and other payments.) Give this form to your payer. Do not send it to the IRS. OMB No. 1545-0074 . 1 . Your first name and middle initial Last name . 2 . Your social security number . 3 . Home address (number and street or rural route) City or town State ...
[PDF File]AUTHORIZATION, AGREEMENT B. Request Status …
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I acknowledge that this agreement does not in any way commit the Government to continue my employment. I understand that if there is a transfer of my service obligation to another Federal agency or other organization in any branch of the Government, the agreements will remain in effect until I …
[PDF File]Disability Report- Adult
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Offices are also listed under U. S. Government agencies in your telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). You may send comments on our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this address, not the completed form.
[PDF File]Form W-9 (Rev. October 2018)
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City, state, and ZIP code. Requester’s name and address (optional) 7. List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN).
[PDF File]CMS-L564 Request for Employment Information
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REQUEST FOR EMPLOYMENT INFORMATION WHAT IS THE PURPOSE OF THIS FORM? In order to apply for Medicare in a Special Enrollment ... City State. Zip Code 4. Applicant’s Name. 5. Applicant’s Social Security Number ... Baltimore, MD 21244-1850. INSTRUCTIONS: Form CMS-L564 (CMS-R-297) (0 9/1 6) 3 Form Approved
[PDF File]Supplemental and Optional Contact Information for HUD ...
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OMB Control # 2502-0581 Exp. (02/28/2019) Supplemental and Optional Contact Information for HUD-Assisted Housing Applicants SUPPLEMENT TO APPLICATION …
[PDF File]CMS 1763 Request for Termination of premium Hospital an/or ...
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REQUEST FOR TERMINATION OF PREMIUM HOSPITAL ... CITY, STATE, ZIP CODE ADDRESS (Number and Street, City, State and Zip Code) ... Baltimore, Maryland 21244-1850. Form CMS-1763 . Title: CMS 1763 Request for Termination of premium Hospital an/or supplementary Medical insurance
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