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[PDF File]STATE OF LEGAL RESIDENCE CERTIFICATE
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state of legal residence certificate data required by the privacy act of 1974 authority: purpose: routine uses: mandatory or voluntary disclosure: tax reform act of 1976, public law 94-455.
[PDF File]2018 Form 990-EZ
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Form 990-EZ (2018) Page . 2 Part II Balance Sheets (see the instructions for Part II) Check if the organization used Schedule O to respond to any question in this Part II . . . . . . . . . .
[PDF File]Form W-4V (Rev. February 2018)
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Form W-4V (Rev. February 2018) Department of the Treasury Internal Revenue Service . Voluntary Withholding Request (For unemployment compensation and …
[PDF File]Report of Motor Vehicle Accident
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MV-104 (5/11) PAGE 2 of 2 . SECTION A . You must report within 10 days any accident . occurring in New York State . causing a fatality, personal injury or damage over $1,000 to the property of any one person. Failure to do so within 10 days is a misdemeanor. Your license and/or registration may be suspended until a
[PDF File]2019-2020 Student Planning Calendar
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June 2019 December 2019 U M T W R F S U M T W R F S 1 1 2 3 4 5 6 7 2 3 4 5 6 7 8 8 9 10 11 12 13 14
[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 …
[PDF File]WORK SEARCH RECORD - Pennsylvania
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WORK SEARCH RECORD FOR WEEK BEGINNING SUNDAY . THROUGH SATURDAY . To be eligible for UC beneits, complete the work search record below. Refer to your Pennsylvania UC Handbook (Form UCP-1) or go to . www.uc.pa.gov. for complete instructions or …
[PDF File]DEVELOPMENTAL COUNSELING FORM - United States Army
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Plan of Action (Outlines actions that the subordinate will do after the counseling session to reach the agreed upon goal(s). The actions must be
[PDF File]Federal Employee's Notice of Traumatic Injury and Claim ...
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Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. Employee: Please complete all boxes 1 - 15 below. Do not complete shaded areas. Witness: Complete bottom section 16. Employing Agency (Supervisor or Compensation Specialist): Complete shaded boxes a, b, and c. Employee Data. 1.
[PDF File]MEDICARE ENROLLMENT APPLICATION
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cms-855i see page 1 to determine if you are completing the correct application. see page 3 for information on where to mail this completed application. see section 12 for a list of supporting documentation to be submitted with this application. to view your current medicare enrollment record go to: https://pecos.cms.hhs.gov
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