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[PDF File]2018 Form 1040
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City, town or post office, state, and ZIP code. If you have a foreign address, attach Schedule 6. Full-year health care coverage or exempt (see inst.) Presidential Election Campaign (see inst.) You . Spouse. If more than four dependents, see inst. and here Dependents (see instructions): (2) Social security number (3) Relationship to you (4)
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[PDF File]Request for Social Security Earnings Information
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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 understand that any false representation to knowingly and willfully obtain information from Social Security records is punishable by a fine of not more than $5,000 or one year in prison.
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[PDF File]FL-150 INCOME AND EXPENSE DECLARATION
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Income (For average monthly, add up all the income you received in each category in the last 12 months and divide the total by 12.) FL-150 [Rev. January 1, 2019]
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[PDF File]VAMC SLUMS Examination - School of Medicine
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SH Tariq, N Tumosa, JT Chibnall, HM Perry III, and JE Morley. The Saint Louis University Mental Status (SLUMS) Examination for Detecting Mild Cognitive Impairment and Dementia is more sensitive than the Mini-Mental Status Examination (MMSE) - A pilot study. J am Geriatri Psych ( in press). 2 3 Questions about this assessment tool? E-mail aging ...
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[PDF File]Request for Leave or Approved Absence
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Request for Leave or Approved Absence. 1. Name (Last, first, middle) 2. Employee or Social Security Number (Enter only the last 4 digits of the Social Security Number (SSN))
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[PDF File]Application for Social Security Card
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Form SS-5 (08-2011) ef (08-2011) Destroy Prior Editions. Page 1. Application for a Social Security Card. Applying for a Social Security Card is . free! USE THIS APPLICATION TO: Apply for …
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[PDF File]Vaccine Information Statement: Inactivated Influenza Vaccine
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fflce use only 4 Risks of a vaccine reaction Soreness, redness, and swelling where shot is given, fever, muscle aches, and headache can happen after influenza …
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[PDF File]AUTHORIZATION, AGREEMENT B. Request Status …
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Education Level (click link to view codes or go to page 7) 14. Pay Plan 15. Series 16. Grade 17. Step 1a. Name and Mailing Address of Training Vendor ... Home Address - Employee's home address, include the street number, city, state, and zip code. 5. Home Telephone Number - Employee's area code, home telephone number.
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[PDF File]Daily Hog and Pork Summary - Agricultural Marketing Service
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EASTERN CORNBELT - LM_HG210: Change from Prior Day: NATIONAL DAILY PORK REPORT FOB PLANT- LM_PK602: Carcass Cutout Values 74.12 Change: (-1.17) Primal Loin
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[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).
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