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    • [PDF File]Health Benefits Election Form

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      Health Benefits Election Form Form Approved: OMB No. 3206-0160 Standard Form 2809 ... Office toll-free at 1-888-767-6738. 3. Former spouses eligible to enroll in or currently enrolled in the ... Enter email address, if applicable, for this family member. Item 24. Enter preferred telephone number, if …

    • [PDF File]Medicare & You Handbook 2020

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      4. Get started. If you’re new to Medicare: • Learn about your Medicare choices. There are 2 main ways to get your Medicare coverage—Original Medicare and Medicare Advantage.

    • [PDF File]Request for Social Security Earnings Information

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      Form . SSA-7050-F4 (03-2019) Page 2 of 4. REQUEST FOR SOCIAL SECURITY EARNING INFORMATION . 1. Provide your name as it appears on your most recent Social …

    • [PDF File]Form W-9 (Rev. October 2018)

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      (Applies to accounts maintained outside the U.S.) 5. Address (number, street, and apt. or suite no.) See instructions. 6. City, state, and ZIP code. Requester’s name and address (optional) 7. List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) …

    • [PDF File]POS-010 Proof of Service of Summons - California Courts

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      Form Adopted for Mandatory Use PROOF OF SERVICE OF SUMMONS Judicial Council of California POS-010 [Rev. January 1, 2007] POS-010 PROOF OF SERVICE OF SUMMONS ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS:

    • [PDF File]Indiana Parenting Time Guidelines

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      Indiana Parenting Time Guidelines and should be specific in their written agreement. 3. Presumption. There is a presumption that the Indiana Parenting Time Guidelines are applicable in all cases. Deviations from these Guidelines by either the parties or the cou rt that result in …

    • [PDF File]VA Form 10-10EZR

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      VA Form 10-10EZR is used by VA to update your personal, insurance, or financial information after you are enrolled. Please Read Before You Start . . . What is VA Form 10-10EZR used for? SERVICE-CONNECTED (SC): A VA determination that an illness or injury was incurred or aggravated in the line of duty, in the active military, naval or air service.

    • Standard Form 1199A, Direct Deposit Sign-up Form

      CLAIM OR PAYROLL ID NUMBER . Standard Form 1199A (EG) OMB No. 1510-0007 (Rev. August 2012) Prescribed by Treasury Department. DIRECT DEPOSIT SIGN-UP FORM

    • [PDF File]Thrift Savings Plan

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      Check to make sure of the following: You provide your name and account number on each page that you submit to the TSP. You print legibly. You sign all pages you complete (including any extra pages you add) on the same date. You have the same witness sign and date all pages—including any extra pages—after you sign and date the form. The witness cannot be named as a

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