Ldss-2725 (rev. 9/2009) new york state office of children and family services request/response for name and/or address of father of child born out of wedlock (print or type all information) forward original to: nys ocfs putative father registry...
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Life care planning packet ("advance directives" or "health care directives") office of the arizona attorney general tom horne life care planning information and documents 1. 2. 3. 4. greetings from the attorney general general information about...
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Pa r t m e n t of n at u ra l re r s o u ces michigan department of natural resources - customer systems de dnr mi taxidermy tags order by authority of act 451, p.a. 1994 as amended c hig an taxidermy tags must be purchased in packages of 50 from...
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Missouri department of natural resources water protection program, water pollution branch for agency use only check no. form f application for approval or permit for concentrated animal feeding operation date received fee submitted type applied...
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Order form do not resuscitate (dnr) medical orders for scope of treatment (most) the medical orders for scope of treatment (most) form and the do not resuscitate (dnr) form may only be ordered by a physician s office or licensed health care
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North carolina department of health and human services division of health service regulation office of emergency medical services 2707 mail service center raleigh, north carolina 27699-2707 http://.ncdhhs.gov/dhsr/ drexdal pratt, director beverly...
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For office use only atn: new york state insurance fund workers' compensation and disability benefits specialist since 1914 icms #: document control center, 1 watervliet ave. extension, albany, ny 12206 application for new york workers compensation...
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New york state department of health complete this application and return to: new york state department of health adoption information registry p.o. box 2602 albany, new york 10-2602 (518)474-9600 adoption information registry biological sibling...
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New york state department of labor customer registration form date: required items are indicated with asterisk * and bold type please print clearly customer data * 1. social security # - - * 2. last name * 3. first name 4. m.i. 5. date of birth /...
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Missouri department of natural resources hazardous waste program large quantity generator inspection checklist l epa id number telephone number with area code for facilities that generate/accumulate 1, kg (2,200 lbs, or approximately five drums...
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Print clear data return completed form to: state of wisconsin department of natural resources p.o. box 7963 madison, wi 53707 declaration of withdrawal exempt forest tax law form 2450-162 (r 10/10) notice: this form is required for withdrawal of...
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New york state department of taxation and finance claim for refund of new york state estate tax decedent's last name social security number ( ssn ) first name date of death middle initial et-95 (4/09) employer identification number ( ein ) of...
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Office of the new york state comptroller thomas p. dinapoli new york state and local retirement system employees' retirement system police and fire retirement system 110 state street, albany, new york 12244-1 phone: 1-866-805-0990 or 518-474-7736...
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Dtf-17 (8/04) new york state department of taxation and finance department use only application for registration as a sales tax vendor please print or type 1 type of certificate you are applying for (you must check one box; see instructions):...
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Important! in order to be legally valid this form must be printed on yellow paper prior to being completed. ems and medical personnel are only required to honor the form if it is printed on yellow paper. this box will not show up when the form is...
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