Baltimore city school system
[PDF File]Declaration for Federal Employment* OMB No. 3206-0182
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Declaration for Federal Employment* (*This form may also be used to assess fitness for federal contract employment) Form Approved: OMB No. 3206-0182 U.S. Office of Personnel Management. 5 U.S.C. 1302, 3301, 3304, 3328 & 8716
[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]Vaccine Information Statement: Inactivated Influenza Vaccine
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Influenza vaccine does not cause flu. Influenza vaccine may be given at the same time as other vaccines. 3 Talk with your health care provider Tell your vaccine provider if the person getting the vaccine: Has had an allergic reaction after a previous dose of influenza vaccine, or has any severe, life-threatening allergies.
[PDF File]Statement of Death by Funeral Director
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Form SSA-721 (5-2005) ef (8-2008) Use 1-2004 edition until supply is exhausted. SOCIAL SECURITY ADMINISTRATION. STATEMENT OF DEATH BY FUNERAL DIRECTOR. Form Approved OMB No. 0960-0142. NAME OF DECEASED. SOCIAL SECURITY NUMBER
[PDF File]Request for Social Security Earnings Information
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Earnings Recording and Self-Employment Income System (60-0059), the Master Beneficiary Record (60-0090), and the ... City ZIP Code Witnesses must sign this form ONLY if the above signature is by marked (X). If signed by mark (X), two witnesses to the ... Request for Social Security Earnings Information
[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]Form SSA-89 (02-2018) Discontinue Previous Editions Page 1 ...
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Form SSA-89 (02-2018) Discontinue Previous Editions Social Security Administration. Page 1 of 2 OMB No.0960-0760. Authorization for the Social Security Administration (SSA)
[PDF File]For conveyances of real property, or interest therein ...
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For conveyances of real property within New York City, use Form TP-584-NYC. If a recording is not required, send this return and your check(s) made payable to the NYS Department of Taxation and Finance, directly to the NYS Tax Department, RETT Return Processing, PO Box 5045, Albany NY 12205-0045. If not using U.S. Mail, see Publication 55 ...
[PDF File]AUTHORIZATION, AGREEMENT B. Request Status Resubmission ...
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included in the Governmentwide electronic system, (the Enterprise Human Resource Integration system (EHRI) and is subject to all of the published routine uses of that system of records. Effects and Nondisclosure ─ Providing the personal information requested is
[PDF File]Form N-648, Medical Certification for Disability Exceptions
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City State or Province. Zip Code or Postal Code Last Name. First Name Middle Name. Was a phone interpreter used? Yes (If "Yes", the interpreter is not required to complete the information below.) No (If "No", the interpreter is required to complete the information below.) Interpreter Signature.
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