Search results with tag "Legibly"
PRINT OR TYPE ALL INFORMATI ON LEGIBLY AND …
dph.georgia.govprint or type all informati on legibly and correctly below. DPH Rule 511-1-3-.23(1b) provides that a disposition permit may be issued only if: (1) a person authorized by DPH Rule 511-1-3-.19(5) has certified the cause of death; (2) the decedent’s attending physician has given approval for
PLEASE PRINT OR TYPE ALL INFORMATION LEGIBLY AND …
dph.georgia.govPLEASE PRINT OR TYPE ALL INFORMATION LEGIBLY AND CORRECTLY BELOW. Enter total number of copies requested here: _____ Total Amount Due: _____ Section 1: REGISTRANT’S INFORMATION . LEGAL FIRST NAME MIDDLE NAME LAST NAME AT BIRTH SEX DOB (MONTH, DAY, YEAR) PLACE OF BIRTH AGE RACE/ETHNICITY
PLEASE PRINT OR TYPE ALL INFORMAT ION LEGIBLY AND ...
dph.georgia.govPLEASE PRINT OR TYPE ALL INFORMAT ION LEGIBLY AND CORRECTLY BELOW AND SEE INSTRUCTIONS ON BACK. Section 1: CHILD/PARENT’S INFORMATION . STATE FILE NUMBER FACILITY . Please Note: Do not use this form if the mother was married to anyone within 10 months prior to the birth of this child or if,
Month Day Year TYPE OR PRINT LEGIBLY - State
www.state.nj.ustype or print legibly. claim #: 11. date of accident last 2. patient's address (no. street) 6. telephone # (include area code) b. auto accident? c. other accident? 3. city yes. no. yes: no. provider information. last 22. tax i.d. 23. npi 24. specialty 25. facility or …
For school use only INSTRUCTIONS: PRINT YOUR ENTRIES …
www.hawaiipublicschools.orgINSTRUCTIONS: PRINT YOUR ENTRIES LEGIBLY CITIZENSHIP Continue on next page Page 1/4, SIS-10W Rev 12/16 SPAB PRESCHOOL EXPERIENCE Complex Area: LAST HAWAII PUBLIC SCHOOL ATTENDED Last GradeAttended: Year: For school use only STUDENT PERSONAL DATA Ethnicity/Race Observed: _____ Initial _____ Date
The Commonwealth of Massachusetts Department of …
www.mass.govAug 14, 2019 · Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
INSTRUCTIONS FOR COMPLETING THIS FORM …
about.usps.comPlease print this form in English using blue or black ink, pressing firmly so all information transfers to all copies. Complete the declaration fully and legibly…
2602 Request to Rescind Principal Residence Exemption (PRE)
www.michigan.govType or print in blue or black ink. PART 1: PROPERTY INFORMATION Type or print legibly. Use a separate form for each property tax identification number. 1. Property Tax Identification Number 2. Name of Local Unit (Check Township or City) 3. County Township City 4. Street Address of Property (Provide a Complete Address) 5.
Month Day Year TYPE OR PRINT LEGIBLY - New Jersey
www.state.nj.usmri: surgery 15. policyholder's address (no. street) 19. zip code 7. patient birthdate 8. sex
Instructions for Completing the Statement of Information ...
bpd.cdn.sos.ca.govnumbered year, theperiodic filing is due every even year. • If the registration occurred in an odd-numbered year, the periodic filing is due ... online, type or print legibly in black or blue ink. Complete the Statement of No Change (Form LLC-12NC) as follows: Item Instruction Tips . 1. Enter the name of the limited liability
The Commonwealth of Massachusetts Department of …
www.mass.govPlease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom . of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
02-29-2024 SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE ...
travel.state.govPlease Print Legibly Using Black Ink Only DS-5520 02-2021 Page 1 of 3 USE OF THIS FORM This form is completed by the applicant only when specifically requested by a passport agency/center when sufficient evidence of identification is …
Secretary of State DP-1 FILE NO:
dp.cdn.sos.ca.govlegibly print: in black or blue ink. Complete the Declaration of Domestic Partnership (Form DP -1) as follows: Item Instruction Tips . 1. These statements are required by statute and must not be altered. 2a & b. •Enter the current names of Partner 1 and Partner 2. last name.
CERTIFICATE OF ADOPTION FORM 3927 (REVISED 02/2018)
dph.georgia.govplease print or type all information legibly and correctly below. section 1: before adoption . state file number first name of child at birth middle name of child last name of child sex of child date of birth (month, day, & year) place of birth (city, county, & state) mothers name at …
www.dmv.pa.gov APPLICATION FOR TEMPORARY …
www.dot.state.pa.usPLEASE PRINT LEGIBLY OR TYPEWRITE ALL INFORMATION + Shipping and Handling 1 to 50 plates = $7 $ 51 plates and up = $12 = Amt. Check Enclosed $ = Cash Provided $ Indicate number of temporary registration plates desired by class. THE FEE FOR EACH TEMPORARY REGISTRATION PLATE IS $17. (NOTE: PennDOT reserves the right to limit orders of temporary
(see reverse side for instructions and fee information ...
www.dot.state.pa.usPRINT OR TYPE ALL INFORMATION LEGIBLY • DO NOT SEND CASH. DL-135 (2-22) INSTRUCTIONS. 1. A $12.00 non-refundable fee is required for each request. If the Bureau has no record for the information requested or the data supplied is insufficient, the fee will be applied to the cost of the search. 2.
DEPARTMENT OF FOREIGN AFFAIRS Office of Consular Affairs ...
www.philippineconsulatela.orgPlease PRINT entries legibly using black or blue ink only. Supply the necessary information. Indicate “N/A” for entries with no answers. ☐ Tick boxes as appropriate. **(Check One) APPLI ANT’S PASSPORT DETAILS LATEST PASSPORT NUMBER DATE ISSUED STATUS OF CURRENT PASSPORT (CHECK ONE; LEAVE BLANK IF NEW PASSPORT APPLICANT)
FORM REASSIGNMENT OF OWNERSHIP 2447 BY …
dor.mo.govLEGIBLY MISSOURI DEPARTMENT OF REVENUE MOTOR VEHICLE BUREAU REASSIGNMENT OF OWNERSHIP BY REGISTERED DEALER DOR-2447 (08-2015) FORM 2447 ... hand print your name as seller only after the purchaser has signed and hand printed their name. Also record your position with the dealership. You state under penalty of perjury that the …
AMENDMENT OF ASSUMED BUSINESS NAME CERTIFICATE …
www.sosnc.govAMENDMENT OF ASSUMED BUSINESS NAME CERTIFICATE (NCGS 66-71.7) (Please print legibly.) 1. The assumed business name previously registeredis: 2. The real nameof theperson or entity engaging in businessunder assumed
Form 93 - Application for Missouri Boat/Vessel or Outboard ...
dor.mo.govIdentification Number” block. Please write legibly. 10. NEW - Check if the unit is new. 11. USED MO - Check if the purchase of the unit was recorded on a Missouri title. 12. USED OUT-OF-STATE - Check if the purchase of the unit was recorded on an out-of-state title or bill of sale. 13. SURRENDERED TITLE NUMBER STATE - If a title is being ...
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