Which time works for you
[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]Patient Health Questionnaire (PHQ-9)
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If you checked off any problems, how difficult Not difficult at all have these problems made it for you to do your work, take care of things at home, or get ... To monitor severity over time for newly diagnosed patients or patients in current treatment for depression: 1. Patients may complete questionnaires at baseline and at regular intervals ...
[PDF File]2018 Instructions for Form 1041 and Schedules A, B, G, J ...
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We encourage you to use Form 1041-V, Payment Voucher, to accompany your payment of a balance of tax due on Form 1041, particularly if your payment is made by check or money order. Extension of time to file. The extension of time to file an estate (other than a bankruptcy estate) or trust return is 5. 1 / 2. months. Item A. Type of Entity. On ...
[PDF File]Application for Social Security Card
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U.S. hospital record of your birth (created at the time of birth) ... If you are not authorized to work in the U.S., we can issue you a Social Security card only if you need the number for a valid non-work reason. Your card will be marked to show you cannot work and if you do work, we will notify DHS. See page 3, item 5 for more information.
[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]Instructions for Form 2848 (Rev. January 2018)
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Substitute Form 2848 The IRS will accept a power of attorney other than Form 2848 provided the document satisfies the requirements for a power of attorney. See Pub. 216, Conference and Practice Requirements, section 601.503(a). These alternative powers of attorney cannot, however, be recorded on the CAF unless you attach a completed Form 2848.
[PDF File]CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT-1 …
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Conditional Waiver and Release This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change
[PDF File]PISTOL SALES RECORD MICHIGAN STATE POLICE PISTOL …
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The purchaser shall receive two copies of the form and the seller may retain one copy. Within ten days of purchase or acquisition, the purchaser must submit the registry copy to the city, village, or
[PDF File]Form W-9 (Rev. October 2018)
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If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien;
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