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doc ico   APPLICATION(S) FOR CERTIFICATE OF TITLE TO A MOTOR …

A false statement is in violation of section 2921.13 of the Ohio Rev ised Code and is punishable by six months imprisonment and a fine of up to one thousand dollars or both. All transfers are audited by the Department of Taxation. The seller and buyer must provide …
publicsafety.ohio.gov/links/bmv3774.pdf   Download

doc ico   Employer's Guide to the Family and Medical Leave Act

assistance to employers and helping increase their knowledge of the law. This Employer’s Guide to the Family and Medical Leave Act is designed to provide essential information about the FMLA, including information about employers’ obligations under the law and the options available to employers in administering leave under the FMLA.
https://www.dol.gov/whd/fmla/employerguide.pdf   Download

doc ico   OCA Official Form No.: 960 AUTHORIZATION FOR RELEASE OF ...

of the HIPAA-compliant Authorization Form to Release Health Information Needed for Litigation This form is the product of a collaborative process between the New York State Office of Court Administration, representatives of the medical provider community in
www.nycourts.gov/forms/Hipaa_fillable.pdf   Download

doc ico   Direct Deposit Signup/Change Form - Paychex

Paychex, Inc. I have reviewed the information provided and it is accurate to the best of my knowledge. My signature below indicates ... EMPLOYEE/WORKER CONFIRMATION STATEMENT ... Financial Institution Financial Institution (“Bank”) Name I wish to deposit (check …
https://www.paychex.com/a/d/clients-employees/dp0002.pdf   Download

doc ico   REQUEST FOR VERIFICATION CASE NAME: CASE NUMBER

REQUEST FOR VERIFICATION CALIFORNIA DEPARTMENT OF SOCIAL SERVICES ... If proof does not exist, you may be able to sign a sworn statement instead. (A sworn statement is only allowed for certain types of proof.) ... School grants/loans/financial aid statements
www.cdss.ca.gov/cdssweb/entres/forms/English/CW2200.pdf   Download

doc ico   Affidavit of Loss/Release of Interest

Affidavit of Loss/ Release of Interest When completed, mail or take this form to any vehicle licensing office. If mailing, you must have your signature notarized. License plate/Registration number Vehicle Identification Number (VIN) or Vessel Hull Identification Number (HIN) Model year Make Model Body style. Affidavit of loss
www.dol.wa.gov/forms/420040.pdf   Download

doc ico   Sample letter of recommendation - University of California ...

Sample’letter’of’recommendation’ intellectual creativity necessary to complete an advanced graduate degree. I would therefore highly recommend Jane Doe. If her performance in my class is a good indication of how she would perform as a graduate student, she would be …
gsi.berkeley.edu/media/sample-recommendation-letter.pdf   Download

doc ico   Health Benefits Election Form - OPM.gov

Office toll-free at 1-888-767-6738. 3. Former spouses eligible to enroll in or currently enrolled in the FEHB Program under the Spouse Equity law or similar statutes. 4. Individuals eligible for Temporary Continuation of Coverage (TCC) under the FEHB Program, including: • Former employees (who separated from service); •
https://www.opm.gov/forms/pdf_fill/sf2809.pdf   Download

doc ico   TENNESSEE DEPARTMENT OF SAFETY AND HOMELAND …

requirement by completing the reverse side of this from and mailing it to the Tennessee Department of Safety and Homeland Security, P.O. Box 945, Nashville, TN 37202. If you have any questions, please call toll-free (866) 903-7357 or the Telecommunications Device for the Deaf (615) 532-2281. Thank you for your cooperation.
https://www.tn.gov/content/dam/tn/safety/documents/owneroperator.pdf   Download

doc ico   DO-NOT-RESUSCITATE (DNR)/PRACTITIONER ORDERS ST L …

The Illinois Department of Public Health (IDPH) Do Not Resuscitate (DNR)/Practitioner Orders for Life Sustaining Treatment (P OLS T) i s alw yv ou ntr.hd ecfm initial medical treatment is begun and the risks and benefits of further therapy are clear, your treatment wishes may change.
www.idph.state.il.us/public/books/dnrform.pdf   Download

doc ico   The Employee’s Guide to the Family and Medical Leave Act

The Employee’s Guide to the Family and Medical Leave Act 5 Expanding Your Family You may take FMLA leave for the birth of a child and to bond with the newborn child, or for the placement of a child for adoption or foster care and to bond with that child. Men and women have the same right to take FMLA leave to bond with their child but it must
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doc ico   OMB Number: 2900-0798 - United States Department of ...

OMB Number: 2900-0798 Estimated Burden: 15 minutes. 1.a Name of Person Claiming Travel Reimbursement (Last, First, Middle) 1.b Claimant's SSN ... Penalty Statement: There are severe criminal and civil penalties including fine or imprisonment, or both, for knowingly submitting a …
https://www.va.gov/vaforms/medical/pdf/vha-10-3542-fill.pdf   Download

doc ico   FS Form 1522 - TreasuryDirect - Home

Special Form of Request for Payment of United States Savings and Retirement Securities Where Use of a Detached Request Is Authorized. IMPORTANT: Follow instructions in filling out this form. Making any false, fictitious, or fraudulent claim or statement to the United States is a crime and may be prosecuted. Print in ink or type all information. 1.
www.treasurydirect.gov/forms/sav1522.pdf   Download

doc ico   2018 Colorado Individual Income Tax Return

4. Subtotal, sum of lines 1 through 3 4 00 5. Subtractions from the DR 0104AD Schedule, line 18, you must submit the DR 0104AD schedule with your return.
https://www.colorado.gov/pacific/sites/default/files/104Formonly.pdf   Download