Request for appointed representative services and direct

DR-835 Florida Department of ... - DM Employer Services

Section 2 – Representative(s) Enter the individual name, firm name (if applicable), address, telephone number(s), and fax number of each individual appointed as attorney-in-fact and representative. If the representatives have the same address, simply write “same” in the appropriate box. If you wish to appoint

  Services, Representative, Appointed

ADVANCE HEALTH-CARE DIRECTIVE OF - Delaware

and the diagnosis, prognosis, care, and treatment thereof upon the request of my Agent I have appointed under this instrument, including, but not limited to, health information as defined and described in the Health Insurance Portability and Accountability Act of 1996 (Public Law 104-

  Directive, Request, Delaware, Appointed

Florida Department of Revenue R. 10/11 POWER OF …

Section 2 – Representative(s) Enter the individual name, firm name (if applicable), address, telephone number(s), and fax number of each individual appointed as attorney-in-fact and representative. If the representatives have the same address, simply write “same” in the appropriate box. If you wish

  Representative, Appointed

Form ET-85 New York State Estate Tax Certification Revised ...

authorized representative listed on the form, unless you direct the department differently. Note: Unless a change in representation or authority is being made, Form ET-14 should only be submitted to the department once. You do not have to send Form ET-14 in with each estate tax form you file. If Form ET-14 was submitted previously,

  York, States, Direct, Estate, Certifications, Representative, York state estate tax certification

Army Cybersecurity - United States Army

tivities may request a waiver to this regula-tion by providing justification that includes a full analysis of the expected benefits and risk. All waiver requests will be endorsed by the commander or senior leader of the requesting activity and forwarded through its higher headquarters to the policy propo-nent. The request must include formal re-

  United, States, Army, Request, United states army, Cybersecurity, Army cybersecurity

Bereavement Instruction form (postal notifications only)

Page 3 of 7 5 Details of account(s) the deceased held with Santander nDo not complete this form for joint non-Investment accounts as ownership of these will transfer to the surviving joint account holder(s). nAll accounts held solely in the deceased’s name, except savings bonds and investments, must be closed.Bond accounts may remain open until ...