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    • [DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal

      https://info.5y1.org/tampa-general-portal-sign-in_1_862ea1.html

      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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    • [PDF File]Declaration for Federal Employment* OMB No. 3206-0182

      https://info.5y1.org/tampa-general-portal-sign-in_1_34736d.html

      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

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    • [DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy

      https://info.5y1.org/tampa-general-portal-sign-in_1_6955d1.html

      navcompt form 3065 (3pt) (rev. 2-83) 1. date of request. 2. for . admin. use only. approval of this leave is . not valid . without control no,

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    • [PDF File]Practitioner and Provider Compliant and Appeal Request

      https://info.5y1.org/tampa-general-portal-sign-in_1_3d260f.html

      Practitioner and Provider Complaint and Appeal Request NOTE: Completion of this form is mandatory. To obtain a review submit this form as well as information that …

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    • [PDF File]Instructions for Form 56 (Rev. November 2017)

      https://info.5y1.org/tampa-general-portal-sign-in_1_79588c.html

      instructions on pages that would otherwise be blank. You can help bring these children home by looking at the photographs and calling 1-800-THE-LOST (1-800-843-5678) if you recognize a child. General Instructions Purpose of Form Form 56 is used to notify the IRS of the creation or termination of a fiduciary relationship under section 6903 and

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    • [PDF File]Application for Social Security Card

      https://info.5y1.org/tampa-general-portal-sign-in_1_2f3b83.html

      Application for a Social Security Card. ... shows your authority to sign the application as well as documents to prove your identity and the identity of the person for whom you are filing the application. We can only accept original documents or documents certified by ... GENERAL: Items on the form are self-explanatory or are discussed below ...

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    • [PDF File]DD Form 1172-2, Application for Identification Card/DEERS ...

      https://info.5y1.org/tampa-general-portal-sign-in_1_743448.html

      Please wait... If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.

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    • [PDF File]Application For Supplemental Security Income (SSI)

      https://info.5y1.org/tampa-general-portal-sign-in_1_fff18e.html

      APPLICATION FOR SUPPLEMENTAL SECURITY INCOME (SSI) Form Approved OMB No. 0960-0229. Page 1. TEL Note: Social Security Administration staff or others who help people apply for SSI will fill out this form for you. I am/We are applying for Supplemental Security Income and any federally administered state supplementation under Title XVI of the Social

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    • [PDF File]VA Form 10-10EZR

      https://info.5y1.org/tampa-general-portal-sign-in_1_2cef92.html

      2. Sign and Date the form. You or an individual to whom you have delegated your Power of Attorney must sign and date the form. If you sign with an "X", 2 people you know must witness you as you sign. They must sign the form and print their names. If the form is not signed and dated appropriately, VA will return it for you to complete.

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    • [PDF File]English 2019 California Driver Handbook

      https://info.5y1.org/tampa-general-portal-sign-in_1_40929b.html

      ~ -You(Kathleen K. Webb, Acting Director California Department of Motor Vehicles B@) Im@•• California Stat English 2019 CALIFORNIA DRIVER HANDBOOK Gavin Newsom, Governor

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