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DS 326, Driver Medical Evaluation - California DMV
DS 326 (REV. 6/2020) WWW Page 1 of 5 DRIVER MEDICAL EVALUATION (Medical information is CONFIDENTIAL under California Vehicle Code §1808.5 CVC) INSTRUCTIONS TO THE DRIVER: Please take this form to the medical professional most familiar with your health history and current medical condition. Before giving this form to your medical professional, complete …
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CERTIFICATE OF NON-OPERATION
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comCERTIFICATE OF NON-OPERATION A Public Service Agency I have knowledge that the vehicle(s) listed below was/were not driven, moved, towed or left standing (parked) upon any California highway
REG 195, Application for Disabled Person Placard or Plates
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comforms will be returned. Use an Application for Replacement Plates, Stickers, and Documents form (REG 156) to request replacement of a lost, stolen, or damaged placard or plates. Attention Disabled Veterans with a service-connected disability: You …
PERMANENT TRAILER IDENTIFICATION (PTI) …
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comPERMANENT TRAILER IDENTIFICATION (PTI) APPLICATION FOR: Certificate of Title (Current Owner completes Side A. To request a Duplicate title, use form REG 227.) Transfer without Certificate of Title (Seller completes Sections 1 and 2, Buyer completes Sections 4 through 7, as needed.) Addition of Legal Owner Without Certificate of Title (To add a legal owner, Sections 1, …
REG 17 A, Special Recognition License Plate Application
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comFirefighter (Surviving Family Member) Issued to a vehicle owned by a firefighter, retired firefighter, or volunteer firefighter or to a surviving family member (spouse, domestic partner, adopted child, stepchild, or recognized natural child, former spouse does not qualify) of a deceased firefighter, retired firefighter, or volunteer firefighter.
) Vehicle License Fee and Transportation Improvement Fee ...
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comTRANSPORTATION IMPROVEMENT FEE EXEMPTION SIDE A – U.S. SERVICEMEMBER USE ONLY (50 U.S.C. §§3998, 4001, 4025) (NATO MEMBERS – SEE FORM REG 5046) VEHICLE IDENTIFICATION NUMBER MAKE OF VEHICLE VEHICLE LICENSE NUMBER You qualify for this exemption if your duty station is located in California and your vehicle is not …
SR 1, Report of Traffic Accident Occuring in California
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comSR 1 (REV. 1/2017) WWW IMPORTANT INFORMATION California law requirestraffic accidents on a California street/highway or private property to be reported to the Department of Motor Vehicles (DMV) within 10 days if there was an injury, death or property damage in excess of $1,000. Untimely reporting
INF 1125, REQUEST FOR OWN DRIVER LICENSE or …
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comINF 1125 (REV. 7/2018) WWW Certify the record as a true copy of record on file with Department of Motor Vehicles (No Charge). DRIVER LICENSE/IDENTIFICATION CARD (DL/ID) OR VEHICLE/VESSEL REGISTRATION (VR) RECORD FEE: $5.00 FOR EACH CURRENT RECORD Write your DL/ID number or plate or VIN on the front or the back of your check.
STATE OFCALIFORNIA APPLICATION FOR REPLACEMENT …
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comAPPLICATION FOR REPLACEMENT PLATES, STICKERS, DOCUMENTS DMV USE ONLY DL/ID/OL NUMBER CA O/S Complete all sections of this form and submit to any DMV office or mail to: DMV, P.O. Box 942869, Sacramento, CA 94269-0001 NOTE: There is a fee to replace most items. If your address has changed, submit the appropriate Change of Address form.
Employer Pull Notice Program Application (INF 1104)
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comAll Employer Pull Notice (EPN) applicants must complete this application in its entirety to avoid processing delays, and pay the required $5 fee for each enrolled driver. Checks must be made out to the California Department of Motor Vehicles (DMV) and submitted with the application. An original signature is required from the Authorized ...
REG 166, Lien Satisfied/Title Holder Release
10up-dmv-wordpress-production-production.s3-us-west-1.amazonaws.comIndex ready This form is used by the legal owner/lienholder of record instead of the Certificate of Title to release interest in a vehicle. The form must be notarized if it will be submitted with an Application for Duplicate California Title. Created Date: 10/12/2007 3:22:49 PM
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Schedule A – Itemized Deductions - IRS tax forms
apps.irs.govNote: Medical and dental floor percentage is 10%. Some senior residences (nursing homes) have an amount in the monthly cost which is a medical expense. Taxpayers can include in medical expenses the cost of medical care in a nurs-ing home, home for the aged or similar institution. This includes the cost of meals and lodging if the principal ...
Extended Health Care Claim Form - Sun Life Financial
www.sunlife.ca• Use this form for all medical expenses and services. For dental expenses, please use the Dental Claim Form. • Please print clearly and be sure all sections are complete to avoid delays in processing your claim. • Attach the original receipt for each expense claimed and keep photocopies for your records.
CLAIMANT'S RECORD OF MEDICAL AND TRAVEL EXPENSES …
www.wcb.ny.govclaimant's record of medical and travel expenses and request for reimbursement. claimant's name . ... nature of expense. date amount. c-257 (11-21) continue on reverse. residential address mailing address (if different) nature of expense. date amount. nys workers' compensation board
EXPIRATION DATE: 10-31-2023 ESTIMATED BURDEN: 1 HOUR ...
eforms.state.govOPTIONAL TESTS: The following tests are not required for a medical clearance determination. The expense of performing these exams is not routinely authorized. The tests may be performed at the clinical discretion of the examiner with patient consent. If performed or previous results are
EMERGENCY MEDICAL SERVICES PERFORMANCE MEASURES
www.ems.govmedical service (EMS) agencies, and the overall performance of local systems . We recognize that many EMS performance measures existed at the beginning of this project and that oth - ers evolved in many geographic, sponsor-specific, and specialty areas during its course . So,