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(F old Here) (Cut along dotted line ) Prescription Drug Plan Administered by CVS Caremark Part D Services, LLC RXBIN: 004336 RXPCN: MEDDADV RXGRP: RXCVSD ISSUER (80840): 9151014609 ID: Name: S5601 Submit Medicare Part D Paper Claims to: Claims Form Processing Box 52066 Phoenix, AZ 85072-2066 SilverScript Customer Care: 1- 866-235-5660 24 hours a day, 7 days a week TTY: 711 Pharmacy Help Desk For Providers: 1- 866-693-4620 Claims administered by CVS Caremark Part D Services, LLC. Welcome to SilverScript (PDP) Confirming Your Membership SilverScript will send a confirmation letter to let you know we received your completed enrollment application.

(Fold Here) (Cut Along Dotted Line) This information is available for free in other languages. Please call our Customer Care number at 1-866-235-5660 (TTY: 711), 24 hours a day, 7 days a week. Esta información está disponible gratuitamente en otros idiomas. Llame a nuestro Cuidado al Cliente, al 1-866-235-5660 (teléfono de texto (TTY): 711 ...

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Mississippi ASSIGNMENT OF LIEN

www.dor.ms.gov

Cut Along Dotted Line . The top half of this form should be kept as a part of your records. APPLICATION FOR TRANSFER OF LIEN. The undersigned assignee confirms transfer of the lien described above and hereby makes application for a new Certificate of Title subject to the following named liens and none other: FIRST LIEN . Lienholder Address City ...

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1350 DEPARTMENT OF REVENUE WH-1601 Withholding Tax …

dor.sc.gov

cut along dotted line SC payments must be made at the same time as federal payments. Business name and address Mail your WH-1601 and payment to: SCDOR Withholding PO Box 100161 Columbia, SC 29202 If you owe $15,000 or more in connection with any SCDOR return, or you make 24 or more payments in a year, you must

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PAVEMENT MARKING DETAILS (SHEET 1 OF 9) - New York …

www.dot.ny.gov

normal dotted lane line (xdll) normal solid double yellow line curvature or taper see contract documents for yellow edge line normal ... be placed along one side of the joint. double line markings shall straddle the joint. where markings normally follow a pavement joint, single line markings shall ...

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This page has been withdrawn because it’s no longer ...

assets.publishing.service.gov.uk

Fold along the short dotted line. Step 4 Take with you when you are going anywhere. I am exempt from wearing a face covering. Be kind. Keep your distance. Thank you for understanding. Print version Cut along here Fold here Step 1 Print this A5 page. Step 2 Cut along the long dashed line. Step 3

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BODY PARTS(I) - KIZCLUB

www.kizclub.com

Cut the page in half and fold along the dotted line. 3. Put the pages in order and staple them together. toes. hand 4 5 elbow leg 2 7 knee. 1 finger 8 6 3 arm foot shoulder. Title: babyanimalbook Created Date:

  Line, Part, Body, Anglo, Dotted, Body parts, Dotted line

2021 Form 1041-V - IRS tax forms

www.irs.gov

• Detach Form 1041-V along the dotted line. • Don’t staple or otherwise attach the payment or Form 1041-V to the return or to each other. Instead, just put them loose in an envelope. • Mail the estate’s or trust’s 2021 tax return, payment, and Form 1041-V to the address shown on the back that applies to you. Cat. No. 54561M Form ...

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Completing Your Timesheet - California Department of ...

www.cdss.ca.gov

You should gently tear the timesheet from your pay stub along the dotted lines. Please be careful not to tear off important information, such as signatures, hours, and dates. If this happens, it will delay your payment as you will need to request a new timesheet from your county IHSS office, and then complete and submit a new timesheet. When

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