Employer s first report of injury or occupational disease wc-1 georgia state board of workers' compensation employer s first report of injury or occupational disease note: failure to submit this report to insurer immediately may result in penalty....
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Ga epd consumer confidence report certification form consumer confidence report certification forms are due to epd offices annually no later than october 1st. community water system name: ga water system i.d. number: (ga) - report year the...
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Print clear page georgia form individual income tax return georgia department of revenue 1 500(rev. 1/09) please print your numbers like this in black or blue ink: please check box if you do not want a booklet next year. 2008 affix label here...
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E do not ma il! pleas state of georgia department of revenue keep these instructions and worksheet with your records instructions 1. download (free) the latest version of adobe reader x http://.adobe.com/products/acrobat/readstep2.html 2. complete...
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Print form georgia department of transportation oversize permit unit if you have any questions, please call () 774-1460 for assistance mailing address: georgia department of transportation oversize permit unit p. o. box 17937 atlanta, ga...
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B. j. walker, commissioner georgia department of human resources office of regulatory services health care section two peachtree street nw suite 33-250 atlanta georgia 30303-3142 (404) 657-5400 fax (404) 657-5442 instructions for x-ray...
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Print form visit us at .humana.com or .humanadental.com humana employee enrollment form - 2-19 employees georgia the offering company(ies) listed below, severally or collectively, as the content may require, are referred to in this application as...
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Form g-2rp(rev. 12/11) print clear withholding on sales or transfers of real property and associated tangible personal property by nonresidents 2. seller's social security or fei number 9. date of sale $ $ $ check here if multiple sellers 1....
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Asbestos disposal manifest form please complete and return with completion form. i. project information: asbestos project: project address: city: state: georgia county: project dates: removal contractor (agent name): license no/expiration: removal...
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Superior court of arizona in maricopa county for clerk's use only case number: name of petitioner order and notice to attend parent information program class name of respondent this is an official court order. if you fail to obey this order, the...
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T-107a (revised 08-2005) odometer discrepancy affidavit purchaser's statement of facts: this is to certify that on , i (date) (purchaser's full legal name) (purchaser's address including city, state & zip) acquired the following vehicle: (year &...
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Separation from employment withdrawal request 401(a) plan state of alaska supplemental annuity plan 98214-03 when would i use this form? when i am requesting a withdrawal and i am no longer employed by the employer/company sponsoring this plan....
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City of savannah zoning board of appeals application 5515 abercorn street savannah, georgia 31405 phone: (912) 651-6530 / tdd: (912) 651-6702 / fax: (912) 651-6543 .savannahga.gov all information must be completed in full before this application...
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