Arizona form 131 2008 claim for refund on behalf of deceased taxpayer refund claim for calendar year y y y y or other tax year beginning m m d d y y y y and ending m m d d y y y y . please print or type 1 decedent s name (last, ?rst, middle...
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Inquiry about status of i-551 permanent registration card u.s. department of justice immigration and naturalization service please wait at least 90 days after entry or after adjustment before inquiring. if this form is folded at the lines in the...
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Print form mallinckrodt institute of radiology barnesjewish hospital physician request form for i131 mibg imaging use this for m only if i131 mibg r eally is intended r ather than i123 mibg instructions: fax completed form to (314) 4548254. we...
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Form b i-131 therapy experience log resident name date dose administered program & number preceptor (au) print & sign name ? 33mci 1. print name sign name 2. print name sign name 3. print name sign name date dose administered preceptor (au) print...
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Mallinckrodt institute of radiology - barnes-jewish hospital physician request form for radioiodine uptake and/or treatment instructions: fax completed form to (314) 362-0414. we will call back with the date and time for the uptake study. call...
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Application for travel document uscis form i131 department of homeland security u.s. citizenship and immigration services omb no. 16150013 expires 03/31/2016 action block receipt to be completed by an attorney/ representative, if any. for uscis...
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Immigration casework intake sheet member of congress: doris matsui petitioner/applicant: name: date of birth: alien number (if any): country of birth: beneficiary: name: date of birth: alien number (if any): country of birth: * uscis receipt...
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Universit y of virginia hea lth system place label here. if label not available, write in pt name & mr# 0701 nuclear medicine nrc written directive for i131 doses less than 30 mci and other therapeutic compounds note: seek guidance from nm md or...
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Nuclear medicine nrc written directive and basis for authorizing release for i-131 doses greater than 30 mci note: seek guidance from nm md or chief tech if directives or procedures are not understood. oral directives are not acceptable. patient...
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Arizona form 131 claim for refund on behalf of deceased taxpayer please print or type. for calendar year 20yy or other tax year beginning m m d d y y y y and ending m m d d y y y y . 1 decedent's name (last, first, middle initial) 2 date of death...
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Substitution request (after the bidding/negotiating phase) project: * add project name substitution request number: ( for architect to fill in ) from: * add your name & company name * add request date to: * add architect, eor or gc date: a/e...
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Seller's report of sales tax due on a casual sale st-131 (11/11) new york state department of taxation and finance use this form to report and remit sales tax on sales of taxable items. do not use this form if you are required to register as a...
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Department of homeland security u.s. citizenship and immigration services form i-508f, waiver of rights, privileges, exemptions, and immunities instructions omb no. 1615-0025; expires 11/30/2011 form i-508f is used to comply with section 247(b) of...
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I-912p, 2012 hhs poverty guidelines for fee waiver request department of homeland security u.s.citizenship and immigration services 2012 hhs poverty guidelines* for the 48 contiguous states, the district of columbia, puerto rico, the u.s. virgin...
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Department of homeland security u.s. immigration and customs enforcement record of determination/parole determination worksheet alien's claimed name(s) (including akas) a#(s) detention facility name and location field office this worksheet should...
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