Illinois high school report card
[PDF File]Enhanced Driver's License and ID Card Identification ...
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13. American Indian card (From I -872) or Minn. tribal identification card that meets the requirements of Minn. Stat.§ 171.072 14. Valid city, county, state or federal employee identification card 15. U.S. high school ID card with a certified transcript from the school, both issued no more than 180 days before the EDL of EID application 16.
[PDF File]Windfall Elimination Provision
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SocialSecurity.gov (over) Windfall Elimination Provision. Your Social Security retirement or disability benefits can be reduced. The Windfall Elimination Provision can affect how we
[PDF File]Form W-9 (Rev. October 2018)
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you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
[PDF File]APPLICATION FOR CERTIFICATE OF TITLE AND REGISTRATION
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The information, including Social Security Number, is requested in accordance with Virginia Code §§46.2-623 and 46.2-629. Any person who refuses to supply the required information will be denied a certificate of title and/or registration.
[PDF File]Statement of Death by Funeral Director
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Children age 18 - 19, if they attend elementary school or high school full time. ... dies, in many situations we can change your payments to survivors benefits once you report the death to us. Benefits for any children will also automatically be changed to survivors benefits
[PDF File]PHQ-9* Questionnaire for Depression Scoring and ...
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PHQ-9* Questionnaire for Depression Scoring and Interpretation Guide For physician use only Scoring: Count the number (#) of boxes checked in a column. Multiply that number by the value indicated below, then add the subtotal to produce a total score. The possible range is 0-27. Use the table below to interpret the PHQ-9 score.
[PDF File]Patient Health Questionnaire (PHQ-9)
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Note: Since the questionnaire relies on patient self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the patient understood the questionnaire, as well as other relevant information from the patient.
[PDF File]Mini-Mental State Examination
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Abnormal for high school education Abnormal for college education Severity 24-30 18-23 0-17 No cognitive impairment Mild cognitive impairment Severe cognitive impairment Sources: • Crum RM, Anthony JC, Bassett SS, Folstein MF. Population-based norms for the mini-mental state examination by age and educational level. JAMA. 1993;269(18):2386-2391
[PDF File]MEDICARE CREDIT BALANCE REPORT
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to complete a Medicare Credit Balance Report (CMS-838) to help ensure that monies owed to Medicare are repaid in a timely manner. The CMS-838 is specifically used to monitor identification and recovery of “credit balances” owed to Medicare. A credit balance is an improper or excess payment made to a provider as the result of patient billing
[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 …
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