Exhibit a2 authorization to order under state contract sbc global services, inc., dba at&t global services on behalf of pacific bell telephone company, dba at&t california (at&t or "contractor ") and the state of california ( "state ") have...
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Return to agenda next agenda item commission agenda: memorandum housing finance authority 2605 enterprise rd. e., ste. 230 clearwater, fl 33759 phone: 727.223.6418 ,.f e.ji ii 18 pinellas (ounty to: the honorable chair and members of the board of...
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504 north third avenue po box 28, rockaway beach, or 97136 (503) 3552 fax (503) 3553434 employee programs and benefits authorization to release copy for schoolbased criminial history background check i, , give name of applicant name of former...
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Trading authorization/power of attorney and indemnification form: domestic this document constitutes a power of attorney, designed to give a designated person either (1) limited trading authorization or (2) full trading authorization over a...
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Bcn behavioral health medication management registration form fax authorization requests to 734-332-2519. questions? call 800-688-3290. member information member last name: member first name: member id #: member date of birth (mm/dd/y): primary...
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Letter of authorizationi hereby authorize ministry of manpower singapore or dataflow services india privatelimited, its authorized affiliates, agents and subsidiaries, acting on its behalf to verifyinformation, documentation and back ground...
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02:16 tuesday, may 08, 2012 1 data set name: sh01.sas7bdat num variable 1 sh01 record length 2 sh01 keypunch code 3 sh01 batchdate 4 sh01 verifyer code 5 sh01 date last modified 6 sh01 time last modified 7 sh01 edit status code 8 shepid 9 formnum...
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Sport coach emergency medical authorization tyrone area high school athletics please print date: athletes name parents name birth date address age phone no grade office/work/other phone no phone no family physician date of last tetanus shot...
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Form 61l courts of justice act notice of election to proceed with cross-appeal (general heading in accordance with form 61b) notice of election the respondent elects to proceed with the cross-appeal. (date) (name, address and telephone number of
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Letter of reference for 2016 nmscpa scholarships applicant: last name first name evaluator: the applicant above is applying for a scholarship from the new mexico society of certified public accountants. please complete the three statement fields...
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Fehb program carrier letter u.s. office of personnel management healthcare and insurance all communityrated carriers letter no. 201610 feeforservice n/a subject: date: may 18, 2016 experiencerated hmo n/a communityrated hmo 9 claims data...
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Childs name: parents name: signature: date: camp members: $100/day or $360/4days nonmem: $110/day or $400/4 days ext. day members: $7/hr nonmem.: $9/hr payment cash credit card check house charge please fill out if paying by credit card type # exp...
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Stock transfer authorization letter date: to: from: broker name donor name(s) brokerage firm address city, state, zip account number address city, state, zip dear sir or madam: i authorize you to electronically transfer the following shares from...
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Tuberculosis skin testwhat is tb? the disease tb is spread by tiny bacteria that can float in the air after someone whohas tb has exhaled. anyone nearby can inhale the bacteria and become infected. it is aninfection of the lungs. it is common in...
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Exhibit h business electricity authorization new hampshire medium and large commercial sales service information service type: new service switching service provider renewal business name ("customer"): service address: city: ldu account no: see...
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