English word list download
[PDF File]EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET
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all inspections and equipment conditions recorded on this form have been determined in accordance with diagnostic procedures and standards in the tm cited hereon.
[PDF File]USCIS Form I-9
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Employment Eligibility Verification Department of Homeland Security U.S. Citizenship and Immigration Services Form I-9 07/17/17 N Page 1 of 3 START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of …
[PDF File]Patient Health Questionnaire (PHQ-9)
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PHQ-9 Patient Depression Questionnaire For initial diagnosis: 1. Patient completes PHQ-9 Quick Depression Assessment. 2. If there are at least 4 3s in the shaded section (including Questions #1 and #2), consider a depressive
[PDF File]IRS 8300 Report of Cash Payments Over $10,000 FinCEN 8300 ...
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• The meaning of the word “currency” for purposes of 31 U.S.C. 5331 is the same as for the word “cash” (See Cash under Definitions, later). General Instructions Who must file. Each person engaged in a trade or business who, in the course of that trade or business, receives …
[PDF File]Form 2848 Power of Attorney For IRS Use Only Received by ...
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A separate Form 2848 must be completed for each taxpayer. Form 2848 will not be honored for any purpose other than representation before the IRS. 1. Taxpayer information. Taxpayer must sign and date this form on page 2, line 7. Taxpayer name and address . Taxpayer identification number(s) Daytime telephone number . Plan number (if applicable)
[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))
[PDF File]TINETTI BALANCE ASSESSMENT TOOL
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TINETTI BALANCE ASSESSMENT TOOL GAIT SECTION Patient stands with therapist, walks across room (+/- aids), first at usual pace, then at rapid pace. Risk Indicators: Tinetti Tool Score Risk of Falls ≤18 High 19-23 Moderate ≥24 Low Date Indication of gait (Immediately after told to ‘go’.) Any hesitancy or multiple attempts = 0 No hesitancy = 1
[PDF File]Form I-693, Report of Medical Examination and Vaccination ...
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I can read and understand English, and I have read and understand every question and instruction on this form and my answer to every question. A. NOTE: Select the box for either . Item A. or . B. in . Item Number 1. If applicable, select the box for . Item Number 2. B. Date of Birth (mm/dd/yyyy) Your Full Name. C. City/Town/Village of Birth. F.
[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]Application for Social Security Card
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9.B., 10.B. If you are applying for an original Social Security card for a child under age 18, you MUST show the parents' Social Security numbers unless the parent was never assigned a Social Security number. If the number is not known and you cannot obtain it, check the “unknown” box. 13.
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