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[PDF File]Instructions for Form SS-4 (Rev. December 2017)
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filing area as shown in the instructions for the form that you are filing. Make your check or money order payable to the “United States Treasury” and show your name (as shown on Form SS-4), address, type of tax, period covered, and date you applied for an EIN.

[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]2014 Code of Ethics
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may choose to refuse services. In this case, counselors will, to the best of their ability, discuss with the client the potential consequences of refusing counseling services. A.3. Clients Served by Others When counselors learn that their clients are in a professional relationship with other mental health professionals, they

[PDF File]MEDICARE ENROLLMENT APPLICATION
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Do not use pencil. ... will be displayed to choose from. • The MAC may request additional documentation to support and validate information reported on this application. You are responsible for providing this documentation within 30 days of the request per ... Medical or other Professional School (Training Institution, if non-MD) Year of ...

[PDF File]Request for Leave or Approved Absence
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Furnishing the social security number, as well as other data, is voluntary, but failure to do so may delay or prevent action on the application. If your agency uses the information furnished on this form for purposes other than those indicated above, it may provide you with an additional statement reflecting those purposes.

[PDF File]Form W-9 (Rev. October 2018)
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If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See . What is backup withholding, later. Cat. No. 10231X. Form . W-9 (Rev. 10-2018) Form W-9 (Rev. 10-2018) Page . 2 By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a

[PDF File]Form I-864, Affidavit of Support Under Section 213A of the INA
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(Do not include any relative listed on a separate visa petition.) No (Applicable only if you are sponsoring family members in . Part 3. as the second joint sponsor or if you are sponsoring family members who are immigrating more than six months after the principal immigrant) Yes. 4.a. Family Name (Last Name) 4.b. Given Name (First Name) 4.c ...

[PDF File]VA Form 10-10EZR
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You may count your biological children, adopted children, and stepchildren as dependents. These children must be unmarried and under the age of 18, or be at least 18 but under 23 and attending high school, college or vocational school on a full or part-time basis, or have become permanently unable to support themselves before reaching the age ...

Why do you choose this school