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Emeriti Retirement Health Solutions Personal Contribution Form
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Shenandoah Outdoor Adventure Recreation Health And Medical Form
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Comprehensive health form for participants in Shenandoah University outdoor and adventure recreation programs, collecting medical history and emergency contact information.
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NEW YORK STATE COVID 19 PAID LEAVE REQUEST FORM
PDF template
Form for employees to request paid leave due to COVID-19 quarantine or isolation orders in New York State.
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Completing The 2020 Form 5498 After IRS Guidance Related To The SECURE Act And The CARES Act
PDF template
A detailed guide for preparing IRS Form 5498 for tax year 2020, addressing special relief and guidance related to the SECURE Act and CARES Act.
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TOWN OF WILTON TIME OFF REQUEST FORM
PDF template
A form for employees to request time off from work, specifying type of leave and dates.
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Incident Report
PDF template
A form used to document workplace incidents, accidents, illnesses, or exposures for the University of New Mexico-Taos.
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Application For Identification Card
PDF template
Official form for obtaining identification cards to access CBP security areas for employees involved in importing and handling merchandise.
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NARFE PAC Contribution Form
PDF template
A form for NARFE members to make voluntary political action committee contributions with various donation levels and pin recognition.
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2022 2023 STUDENT EMERGENCY CONTACT FORM
PDF template
A comprehensive form for collecting student contact details, emergency contacts, and medical information for school records.
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POGS Sickness Benefit Application Form
PDF template
Application form for members of the Philippine Obstetrical and Gynecological Society to claim sickness benefits
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AU Direct Deposit Authorization 2019
PDF template
A form for employees to authorize automatic deposit of payroll funds into one or two bank accounts at Antioch University.
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Change Of Address Form
PDF template
Form for retirees, beneficiaries, or separated members to update contact information with the Fort Worth Employees Retirement Fund.
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Idaho Health Examination And Consent Form
PDF template
Required medical examination form for Idaho high school students participating in interscholastic athletics in 9th and 11th grades.
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Overwatch Contribution Form
PDF template
Contribution form for donating to the Helmets to Hardhats program supporting military service members' transition to civilian employment.
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Income Tax Withholding Form
PDF template
Form for electing income tax withholding options for pension payments from Imperial County Employees' Retirement System
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Ardelle Associates Leave Request Form
PDF template
A form for employees to request Paid Time Off (PTO) or Sick Leave with supervisor approval requirements.
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2021 States 4 H OB Medical Form (Non Japan)
PDF template
Medical history and health assessment form for participants in a cross-cultural youth exchange program.
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Cardiology Medical History Form
PDF template
Comprehensive medical history form for cardiology patients to document health conditions, medications, and allergies.
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TRS Medicare Eligible Health Plan (MEHP) Prescription Drug Benefit Guide
PDF template
Detailed guide for Teachers' Retirement System of Kentucky Medicare Part D prescription benefit plan managed by Know Your Rx Coalition through Express Scripts
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Privit Profile Instructions For Students
PDF template
Comprehensive guide for students to create and complete their digital health record using Privit Profile platform for Wilmington College.
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Travel Form Instructions
PDF template
Comprehensive instructions for district employees on completing travel forms, obtaining approvals, and reimbursement procedures for business travel.
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Manchester Employees Contributory Retirement System Additional Contribution Calculation Request
PDF template
A form for Manchester employees to request calculation of additional retirement contributions and explore retirement benefit options
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POGS MAP Sickness Benefit Application Form
PDF template
A form for members of the Philippine Obstetrical and Gynecological Society to apply for sickness benefits for medical and COVID-related conditions.
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BHC Non Surgical Program Registration Form
PDF template
Registration form for patients seeking admission to a non-surgical program at Boone Hospital Center, collecting comprehensive personal and medical information.
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Caltech United Way Campaign 2022 One Time Contribution Form
PDF template
A form for making one-time charitable donations through the Caltech United Way Campaign for 2022, allowing contributors to allocate funds to various organizations.
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EMPLOYEE AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT
PDF template
A document allowing employees to authorize direct deposit of wages and provide banking details for payroll processing.
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University Of Michigan Prescription Drug Plan Guide
PDF template
Comprehensive guide for managing prescription drug benefits through Magellan Rx Management for University of Michigan employees and members.
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Adult Medical Release Form
PDF template
Medical information and emergency authorization form for adult participants of the Summit Music Festival
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HEALTH ASSESSMENT FORM
PDF template
A screening questionnaire to assess potential COVID-19 exposure and symptoms for convention attendees.
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City Of Kenosha Health Savings Account (HSA) Payroll Deduction Form
PDF template
Form for City of Kenosha employees to set up or modify Health Savings Account payroll deductions through Johnson Bank.
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Long Term Disability Claim Form Statement Of Employee
PDF template
A comprehensive form for employees to file a long-term disability claim with Lincoln Financial Group, detailing personal, employment, and medical information.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical form for documenting student's health history, childhood illnesses, current physical conditions, and immunization records.
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Employee Timesheet
PDF template
A timesheet document for tracking employee work hours and certifying time worked for staffing and payroll purposes.
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Easter Seals Colorado Rocky Mountain Village Camper Medical Form
PDF template
A comprehensive medical form for documenting a camper's health status and medical history prior to attending camp.
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Retirement Offboarding
PDF template
Comprehensive guide for employees preparing to retire, outlining notice requirements, resignation procedures, and transition steps.
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2023 2024 Northside ISD Medical History
PDF template
Annual medical history form required for student participation in athletic activities at Northside Independent School District.
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Annual Pre Participation Physical Evaluation
PDF template
A comprehensive medical screening form for student-athletes to assess their health and fitness for sports participation during the 2023-24 school year.
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2023 2024 Student Emergency Form
PDF template
A comprehensive form for collecting student emergency contact details, health insurance information, and parental contact information for school records.
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Manchester Employees Contributory Retirement System Additional Contribution Calculation Request
PDF template
A form allowing employees to request calculation of additional retirement contributions with specific authorization and salary assumptions.
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Flexible Spending Account (FSA) Enrollment Form
PDF template
A form for employees to elect and contribute to Flexible Spending Accounts for health care and dependent care expenses
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Delaware State Tax Withholding Form
PDF template
A form for pensioners to elect their Delaware state tax withholding preferences for monthly pension benefits.
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2023 Teen Expeditions Questionnaire And Medical Form
PDF template
Comprehensive medical questionnaire for participants of Lake Champlain Maritime Museum teen expeditions to ensure safety and proper medical support.
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LSCU FedPAC Payroll Deduction Authorization Form
PDF template
A voluntary form for employees to authorize recurring payroll deductions for political action committee contributions at different contribution levels.
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Flexible Spending Account Agreement Form
PDF template
A form for employees to elect and set up Flexible Spending Accounts for healthcare and dependent care expenses.
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Preparticipation Physical Evaluation History Form
PDF template
Comprehensive medical history form for athletes to evaluate health status and potential medical concerns prior to sports participation
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Fulton County Government Authorization For Payroll DeductionHealth Savings Account Contribution
PDF template
A form for Fulton County employees to authorize health savings account (HSA) contributions through payroll deductions for the 2023 plan year.
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2023 HSA Voluntary Salary Reduction Form
PDF template
Form for employees to start, change, or cancel pre-tax contributions to a Health Savings Account (HSA) through payroll deduction
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SupervisorS Incident Investigation Form
PDF template
A two-part form for documenting workplace incidents and potential worker injuries for the NEWESD 101 Workers' Compensation Cooperative.
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2023 JCC Maccabi Teen Medical Form
PDF template
Medical examination form for teens participating in JCC Maccabi sports and arts activities to verify physical fitness and health status.
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Form LG03 Local Government Health Insurance Program Cancellation Form
PDF template
A form for cancelling local government health insurance coverage with multiple termination reason options
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Student Medical Information
PDF template
A comprehensive medical form for collecting student health details, emergency contacts, and insurance information for educational program participation.
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New Hire Active Employee Enrollment Form
PDF template
A comprehensive form for new employees to enroll in health, dental, vision, and life insurance benefits with Fulton County, Georgia.
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Nomination Form Leonard W. Sandridge Outstanding Contribution Award
PDF template
A form for nominating an individual for the Leonard W. Sandridge Outstanding Contribution Award within an organization.
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SERS NEWS SpringSummer 2023
PDF template
Newsletter highlighting the 100-year anniversary of the State Employees' Retirement System and tax withholding updates for pension payments
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2024 2025 Benefits Enrollment Form
PDF template
Form for employees to select health benefit plans, add or remove dependents, and update personal information for the upcoming benefits year.
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Group Medical Plan Waiver Form
PDF template
A form for employees to waive medical plan coverage by certifying alternative health insurance coverage and understanding ACA requirements.
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MISD Employee Giving Campaign Payroll Deduction Form
PDF template
Payroll deduction authorization form for employees to donate to the McKinney Education Foundation
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RC 10 SUSTAINING MEMBERSHIP FORM
PDF template
A membership registration form for retired education professionals to join NYSUT Retiree Council 10 with options for membership and scholarship donation.
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TAPPS MEDICAL HISTORY FORM
PDF template
Annual medical history form for students participating in TAPPS athletic and fine art activities to assess health risks.
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Annual Pre Participation Physical Evaluation
PDF template
Medical evaluation form for student-athletes to assess physical fitness and health conditions for sports participation.
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Sports Physical Examination Form
PDF template
Comprehensive medical evaluation form for students participating in school sports, requiring parental authorization and medical provider assessment.
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MEDICAL EXAMINATION FORM
PDF template
Medical form to assess physical and mental fitness of individuals applying for motorcycle event participation licenses.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for capturing individual health details, medical conditions, and consent for medical information sharing.
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Fire Department Pre Retirement
PDF template
Comprehensive guide and checklist for fire department employees preparing for retirement, including conference scheduling and required documentation.
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2024 Pastoral Agreement Form (PAF)
PDF template
A comprehensive form detailing compensation, benefits, and service terms for pastoral staff in the Eastern Regional Conference of Churches of God.
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Payroll Deduct Roth IRA Contribution Form
PDF template
A form for employees to authorize automatic Roth IRA contributions from their paycheck, with special provisions for age 50 and over.
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Presbytery Of Carlisle Contribution Form
PDF template
A form for submitting financial contributions to the Presbytery of Carlisle, including per capita, shared giving, and designated project donations.
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RULES AND REGULATIONS
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Comprehensive guidelines for cattle exhibition at a fair, including entry requirements, health regulations, and ownership rules.
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Delaware State Tax Withholding Form
PDF template
Form for pensioners to elect state tax withholding options for Delaware state taxes on pension benefits.
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DIRECT DEPOSIT CANCELLATION FORM
PDF template
Form for canceling direct deposit of retirement benefit payments for Hanford Employee Welfare Trust retirees.
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2024 CONTRIBUTION FORM
PDF template
A form for collecting annual membership contributions and optional charitable donations for various organizations in the Holy Land.
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Auction Contribution Form
PDF template
A form for organizations and individuals to contribute auction items to support Winterfest, Inc.
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FULL TIME DOMESTIC PARTNERSHIP AUTHORIZATION FOR PAYROLL DEDUCTIONS FOR HEALTH INSURANCE EFFECTIVE Y
PDF template
Authorization form for employees to select health insurance coverage options and allow payroll deductions for Essex County health insurance plans
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2024 Guardian Dental Cancellation Form
PDF template
A form to request cancellation of Guardian Dental insurance coverage by an employee.
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Child Medical Disclosure Form
PDF template
Medical information and emergency contact form for children attending summer camp, including health history and parental consent for medical treatment.
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Kamehameha Schools Summer Programs Medical Forms
PDF template
Medical evaluation and health history form for children participating in Kamehameha Schools Summer Programs, requiring physical examination and immunization documentation.
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HPU Incoming Student Health Information And Immunization
PDF template
Comprehensive health form for incoming students at High Point University, including immunization records and medical consent.
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Health Savings Account (HSA) Contribution Form
PDF template
Form for state and local government employees to authorize HSA payroll contributions and select health plan details.
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HSA Payroll Deduction Form 2024
PDF template
A form for employees to authorize payroll deductions for Health Savings Account contributions with IRS contribution limits and University contribution details.
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Permit To Install Or Alter A Sewage Treatment System
PDF template
Official permit document for installing, replacing, or altering a sewage treatment system in Ohio, issued by the Ohio Department of Health.
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Pre Employment Health Clearance Requirements
PDF template
Comprehensive health screening requirements for new medical residents and fellows, including medical history, immunizations, and occupational health screenings.
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2024 UNC Soccer Camp MEDICAL FORM
PDF template
Medical history and health screening form for participants of UNC Soccer Camp, required for camp participation.
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Medical History And Physical Examination Form
PDF template
Medical history and physical examination document for racing car drivers to assess fitness and health conditions for licensing.
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Jr All American Of Southern California Conference Mandatory Medical Release Form
PDF template
Medical history and physical examination form required for youth athletes participating in Jr All American of Southern California Conference sports programs
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PLAN YEAR 2024 ENROLLMENTCHANGE FORM MEDICAL SPENDING CONVERSION (MSC) HEALTH BENEFITS BUY OUT WAIVE
PDF template
Enrollment form for New York City employees to participate in or terminate health benefits buy-out waiver program for plan year 2024.
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North Carolina Merchants Political Action Committee, Inc. INDIVIDUAL CONTRIBUTION FORM
PDF template
A form for individuals to make political contributions to the North Carolina Merchants Political Action Committee with required personal and payment information.
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PART TIME AUTHORIZATION FOR PAYROLL DEDUCTIONS FOR HEALTH INSURANCE EFFECTIVE YEAR 2024
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A form for part-time employees to authorize health insurance premium deductions with Essex County for the 2024 benefit year.
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Contribution Form
PDF template
A contribution form for making financial donations to support the New York City Police Foundation
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MRTF Member Benefit 2024
PDF template
Comprehensive overview of membership types, benefits, and pricing for the Michigan Roof & Turf Foundation (MRTF) organization.
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Disability Insurance Claim Packet Instructions
PDF template
Instructions for filing a disability insurance claim with Standard Insurance Company, detailing the application process and required documentation.
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Conference RequestTravel Reimbursement Form
PDF template
Form for employees to request and document travel expenses and reimbursement for conference or training activities.
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VADA Termination Or Voluntary Cancellation Form
PDF template
Form for employees to cancel or terminate their employment benefits including medical, dental, vision, disability, and life insurance.
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2024 Vanderbilt Payroll Deduction Form
PDF template
A form allowing Vanderbilt University employees to purchase season tickets via payroll deduction with specific eligibility rules and conditions.
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Benefits Cancellation Form
PDF template
Form for employees to remove dependents from their healthcare or insurance benefits plan.
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University Of Michigan Benefits Enrollment Form
PDF template
Comprehensive guide for employees to elect University of Michigan benefits, explaining enrollment procedures and deadlines.
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Combined Giving, Contribution Election Agreement
PDF template
A form for employees to authorize charitable contributions through payroll deductions for selected agencies.
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Flexible Spending Accounts (FSA) Program Direct Deposit EnrollmentChangeCancellation Form
PDF template
A form for enrolling in or changing direct deposit details for Health Care Flexible Spending Account (HCFSA) and Dependent Care Assistance Program (DeCAP)
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2025 Hall Of Honor Nomination Form
PDF template
Nomination form for recognizing retired faculty or staff members for induction into California State University, Chico's Hall of Honor.
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Disability Insurance Claim Packet Instructions
PDF template
Comprehensive guide for applying for disability insurance benefits through Standard Insurance Company, detailing claim submission process and requirements.
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Health Services Referral Form
PDF template
A comprehensive referral form for various health services targeting children, youth, and pregnant women in Mississippi.
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Form 205 Payroll Direct Deposit
PDF template
A form for employees to set up automatic payroll contributions to my529 education savings accounts.
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Everence HSA Contribution Form
PDF template
A form for making individual contributions to a Health Savings Account through Everence Federal Credit Union with tax year specification options.
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The Insured Funds OneSIPP Drawdown Pension Application Form
PDF template
A pension application form for transferring and joining the Sanlam Personal Retirement Scheme, designed to be completed with a Financial Adviser.
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Employee HSA Payroll Deduction Form
PDF template
A form for employees to authorize payroll deductions for their Health Savings Account contributions with annual contribution limit details.
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MyFitRx And Kids On The Move Reimbursement Form
PDF template
A reimbursement form for members participating in MyFitRx or Kids on the Move fitness programs, offering up to $50 per benefit year.
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Physician Examination Form
PDF template
A comprehensive medical form required for students to provide health information and undergo physical examination prior to campus arrival.
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Progressive Discipline Action Form
PDF template
A structured document for documenting employee performance issues, corrective actions, and disciplinary consequences.
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CCS Administrative Procedure 2.30.05 E Confined Space Entry
PDF template
Administrative procedure outlining safety protocols and requirements for entering confined spaces at Community Colleges of Spokane.
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LEAVE REQUEST FORM
PDF template
A form for employees to request various types of leave from work, including documentation of absence type, duration, and required approvals.
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Student Medical Form
PDF template
Comprehensive medical form for collecting student health information, medical history, and emergency contact details.
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Retiree Benefits Enrollment Form
PDF template
Form for retirees or surviving spouses to enroll or modify health and dental benefits coverage options.
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24 25 Physical Examination Form
PDF template
Medical form for student athletes to document physical fitness and health status for school sports participation.
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Instructions For Forms 1099 R And 5498
PDF template
Official IRS instructions for reporting distributions from retirement accounts, pensions, and other financial plans for tax year 2024.
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Use Of PCC Van (OP P 262)
PDF template
Establishes criteria and process for reservation and use of PCC vans by authorized employees for official college activities.
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Corporate Personal Pension Employee Application Form
PDF template
An employee application form for a corporate personal pension plan with Professional Provident Society Investments.
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Income Tax Withholding For Retirees
PDF template
A form for retirees to specify state income tax withholding preferences, with specific focus on Maryland tax withholding options.
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Change Of Address Form For Housing Benefit And Council Tax Benefit
PDF template
A form for updating residential address details for housing and council tax benefit purposes by Bridgend County Borough Council.
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DSS Form 2901 Medical Statement
PDF template
Medical health form for staff, volunteers, and emergency personnel working in child care services, documenting health history and tuberculosis status.
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Medical Statement
PDF template
A medical health screening form for staff, volunteers, and emergency personnel working in child care settings in South Carolina.
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Medical Statement
PDF template
Medical health screening form for staff, volunteers, and emergency personnel in child care services in South Carolina.
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Change Of Address Form
PDF template
Form for New York City Employees' Retirement System members to update their mailing address and payment preferences.
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GSDCA DM Research Sample Volunteer Form
PDF template
A research form for collecting cheek-swab DNA samples from purebred German Shepherd Dogs to study degenerative myelopathy genetic factors.
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Flexible Spending Account Enrollment Form
PDF template
A form for employees to enroll in flexible spending account benefits and set up direct deposit for reimbursements.
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Initial Interview Form
PDF template
A comprehensive form for veterans or their family members to collect information needed to apply for veterans' benefits.
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Enrollment Form
PDF template
An enrollment form for collecting personal and dependent information for insurance or benefits enrollment with Lincoln Financial Group.
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NARFE PAC CONTRIBUTION FORM
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A donation form for members of the National Active and Retired Federal Employees Association to contribute to NARFE-PAC
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients seeking holistic healthcare at the Riordan Clinic, collecting detailed personal and medical information.
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Direct DepositInformation And Instructions
PDF template
A form for setting up electronic payments from Wespath Benefits and Investments for retirement distributions and protection plan payments.
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Dohn Community High School 301 Wellness Policy Compliance Form
PDF template
A form for documenting wellness committee membership, meeting dates, and policy evaluation for a community high school.
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Request For Payments To Trust TrusteeS Acknowledgment
PDF template
A form for directing State Employees' Retirement System benefit payments to a trust for a minor or legally disabled individual.
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303 Employee Compensation And Leave Time
PDF template
A policy outlining paid time off procedures, compensation, and leave time guidelines for full-time salaried employees at St. George Academy.
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State Employees Charitable Campaign Contribution Form
PDF template
A form for Michigan state employees to make charitable contributions through payroll deduction, check, credit card, or direct bill.
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UC ANR Leave Request Form
PDF template
Form for employees to request and document a leave of absence, including details of leave type, dates, and signatures.
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IRIS Travel Policy And Procedures
PDF template
Comprehensive guidelines and procedures for travel by IRIS employees, covering authorization, costs, transportation, lodging, and reimbursement.
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LDSS 3151 SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) CHANGE REPORT FORM
PDF template
A form for reporting changes in circumstances that may affect Supplemental Nutrition Assistance Program (SNAP) benefits.
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UCPATH DIRECT RETRO REQUEST
PDF template
A form for processing salary expense transfers for UC employees, replacing the previous UCCE Salary Expense Transfer Request form.
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Camp Blue Spruce Medical Form 2016
PDF template
A comprehensive medical form for campers to provide health and emergency contact information for Camp Blue Spruce summer camp.
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Payroll Deduction Form For HSA Contribution
PDF template
A form for employees to designate pre-tax payroll contributions to their Health Savings Account for the plan year.
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Payroll Deduction Form For HSA Contribution
PDF template
A form for employees to elect pre-tax payroll contributions to a Health Savings Account (HSA)
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Election For Online W 2 Delivery Form
PDF template
Form for Texas State University employees to consent to or withdraw from electronic W-2 delivery via online portal
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Administrative Procedure 323 SEPARATION
PDF template
Procedures for nonacademic, administrative, and academic employees terminating employment with the University, including handling of benefits and exit process.
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Employee Performance Review Form Appendix 324A
PDF template
A comprehensive form for evaluating employee performance, goals, and professional development
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Pension Application Form
PDF template
Comprehensive application form for pension insurance covering employer and employee details for individual or group policies.
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Performance Review
PDF template
Comprehensive guide detailing the systematic process for conducting employee performance reviews within the Unified Government organization.
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Ohio Administrative Code Rule 33071 3 04 Military Service Credit
PDF template
Administrative rule detailing military service credit provisions for retirement systems in Ohio, including eligibility and documentation requirements.
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3.4.1p. Employee Access To Facilities
PDF template
Procedure detailing key fob and access control for employees at Ogeechee Technical College, including how access is granted and managed.
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State Income Tax Withholding Form
PDF template
Comprehensive guide for state-specific income tax withholding rules for retirement distributions across different states.
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Form 3503 FR.03 Termination Checklist
PDF template
A comprehensive checklist for HR specialists and departments to follow when processing an employee's termination, covering administrative and equipment-related tasks.
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Title 38 United States Code Section 3679(E) School Compliance Form
PDF template
A compliance form for educational institutions to confirm adherence to veterans' educational benefits requirements under the Veterans Benefits and Transition Act of 2018.
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DSS Form 37113 Contribution Form
PDF template
A form used by the South Carolina Department of Social Services to document financial contributions to a household or benefit group.
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Petitioning For Superior Court Review When You Disagree With A DSHSHCA Benefits Administrative Heari
PDF template
A step-by-step guide for individuals seeking to appeal administrative orders related to DSHS/HCA benefits through Superior Court review process.
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IRS Form W 4P
PDF template
Guide for U.S. citizens and resident aliens on federal and state tax withholding for periodic pension or annuity payments.
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Cerritos College FORMS
PDF template
Comprehensive collection of human resources forms for Cerritos College employees covering various administrative and personnel processes.
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UNC Hurricane Matthew Special Leave Request Form
PDF template
Form for UNC employees to request paid leave due to substantial damage from Hurricane Matthew
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TOWN OF MILLIS EMERGENCY CONTACT FORM
PDF template
A form for employees to provide personal contact information and emergency contact details for workplace safety purposes.
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3 Month Probationary Review
PDF template
Policy and procedure for conducting a 3-month performance review for new employees during their 6-month probationary period.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical form collecting patient personal health information, medical history, family history, and COVID-19 screening details.
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Change Of Address Request Form (For Retirees Beneficiaries)
PDF template
A form for retirees and beneficiaries to update their mailing address with the Employees' and Elected Officials' Retirement Systems.
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The 3 RS To Retirement
PDF template
A comprehensive guide for employees planning to retire, covering the steps of retiring, resigning, and managing retiree health benefits.
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Beneficiary Designation Form
PDF template
Instructions for designating beneficiaries for retirement plans through Prudential's online platform
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Beneficiary Designation Form
PDF template
Instructions for designating beneficiaries for retirement plan accounts online or via paper form with specific processing guidelines.
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401(K) Contribution Authorization Form
PDF template
Form for employees to authorize 401(k) retirement plan contributions through payroll deduction, including pre-tax and Roth options.
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The Muscogee (Creek) Nation 401(K) Plan Rollover Contribution Form
PDF template
A form for participants to transfer retirement funds from a previous plan or IRA into the Muscogee (Creek) Nation 401(k) Plan.
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403(B) Participant EnrollmentPayroll Deduction Form
PDF template
A form for employees to enroll in or update contributions to a traditional or Roth 403(B) retirement plan with payroll deduction authorization.
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Plan Exchange Authorization Form
PDF template
Form for authorizing exchange of 403(b) funds between investment providers within an employer's plan or to purchase service credits.
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Waiver Of Service Period For Retirement Plan Participation
PDF template
A form allowing employees to waive the one-year service requirement for retirement plan participation based on previous employment at eligible organizations.
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Procedure 410 19 Employee Volunteer And Education Leave
PDF template
A policy providing full-time employees with 8 hours of annual leave for volunteer and educational activities in the community.
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Tobacco Free Campus Policy
PDF template
Comprehensive policy prohibiting tobacco use, smoking, and tobacco product distribution on all university property for students, faculty, staff, and visitors.
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Hazard Incident Report Form
PDF template
A form for documenting and reporting workplace safety hazards, incidents, and recommended corrective actions.
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Employee Benefit Plan Enrollment
PDF template
Montgomery County Public Schools form for new employees and those with qualifying life events to enroll in benefit plans
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Utah Retirement System Defined Contribution Service Agreement Form
PDF template
A form for employers to specify participation in Utah Retirement System's defined contribution plans and employee contribution options.
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457 Deferred Compensation Plans Contribution Form
PDF template
Form used to change contribution amounts to a 457 deferred compensation plan account with MissionSquare Retirement.
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Cambria Comm Services District Enrollment And Contribution Form
PDF template
Form for employees to enroll in and contribute to the Cambria Community Services District 457 Deferred Compensation Plan at MissionSquare Retirement.
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North Carolina Supplemental Retirement Plans One Time Contribution Form
PDF template
A form for state employees to defer additional compensation or one-time payments into retirement plans through a single contribution.
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Direct Deposit
PDF template
Procedure for processing employee direct deposit forms, including enrollment, changes, and verification steps.
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HealthFlex Mandatory Premium And Coverage Waiver Form
PDF template
A form for enrolled participants or new hires to decline HealthFlex health plan coverage and declare their reason for doing so.
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Youth Member Health History Information
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A comprehensive health information form for youth members participating in 4-H programs, collecting medical history, medications, and special needs information.
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Personnel Maintenance Request Form
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A form used by East Lake Tarpon Special Fire Control District to manage employee system access, including new user setup, security changes, and employee deactivation.
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DWS ESD 475 Change Report Form
PDF template
A form for reporting changes in various state assistance programs including financial aid, Medicaid, SNAP, and child care benefits.
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SI 2047 Your Disability Benefit Claim
PDF template
Comprehensive guide and forms for applying for disability insurance benefits, including instructions for claim submission and potential benefit reductions.
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COVID 19 Participant Code Of Conduct And Risk Assessment Form
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A risk assessment and conduct guidelines form for Special Olympics participants during the COVID-19 pandemic
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Health Requirements For Matriculation
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Comprehensive health documentation requirements for students, detailing mandatory vaccinations and immunization guidelines.
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Drugs And Alcohol (Athletes) Policy
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Policy governing drug testing and education for student-athletes at Western Nebraska Community College to promote health and fair competition.
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Employer Fact Sheet Contracted Services Membership Determination And The EmployerS Obligation
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Guidance for public educational institutions on determining employment status and retirement system membership for contracted service providers.
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Staff Movement Register
PDF template
A record-keeping tool for tracking staff movements, arrivals, departures, and visits within an organization
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LDSS 5067 NYS OTDA State Supplement Program Direct Deposit Cancellation Form
PDF template
Form for cancelling direct deposit for New York State Supplement Program benefits
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Authorization Form For RIPTA Wave Pass Payroll Deduction
PDF template
A form allowing state employees to authorize payroll deductions for purchasing Rhode Island Public Transit Authority (RIPTA) commuter passes.
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Performance Expectations Feedback Form
PDF template
A formal document for documenting performance deficiencies and required corrective actions for employees.
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5.170 A Separation From Employment Voluntary Separation
PDF template
Policy and procedures for employee separation from Mohave Community College, covering resignation, retirement, death, and separation pay.
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Required NYS School Health Examination Form
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Comprehensive health examination form for New York State school students, capturing medical history and current health status.
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Arbitration Award In Dane County (Public Health) Labor Dispute
PDF template
Arbitration hearing regarding salary continuation benefits dispute between Dane County and District 1199W union
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Employee Emergency Contact Form
PDF template
A document for collecting employee emergency contact information and personal details for workplace safety and communication purposes.
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LEAVE REQUEST FORM
PDF template
A form for employees to request and track various types of leave including annual, sick, personal, and unpaid leave.
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DULA Leave Request Form
PDF template
A form for employees to request various types of leave including sick, vacation, and unpaid leave at Dongguk University Los Angeles.
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Fitness Reimbursement Request
PDF template
Form for members to request reimbursement for qualified fitness expenses through Blue Cross Blue Shield of Massachusetts.
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Leave Program Procedures
PDF template
Detailed procedures for vacation leave accrual and usage for employees at Owens Community College.
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Employee Estimated Expense Approval Form
PDF template
A form for employees to request approval and reimbursement for estimated travel and business expenses.
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Seasonal Survey On Influenza Vaccination Programs For Healthcare Personnel
PDF template
A survey collecting information about influenza vaccination programs and practices for healthcare personnel across different employment groups.
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Fund Contribution Form
PDF template
A form for making financial contributions to a fund through the Community Foundation of Greater Des Moines.
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Household Report Form
PDF template
A form for reporting household information to maintain public assistance benefits in Minnesota.
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Medical Form
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A medical form for applicants to Notre Dame Seminary's Graduate School of Theology Priestly Formation Program, collecting health and insurance information.
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Personal Medical History
PDF template
Comprehensive medical history form for collecting patient health information, medical conditions, family history, and current health status.
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WIGI Bill Residency Affidavit For Children And Spouses Of Eligible 5 Year Veterans
PDF template
A form for children and spouses of veterans to establish residency eligibility for Wisconsin educational benefits
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Career Personnel Performance Review
PDF template
A comprehensive performance review document for assessing an employee's job performance, knowledge, quality, and quantity of work.
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EMPLOYEE LEAVE REQUEST FORM
PDF template
Official state form for employees to request various types of leave from work, including vacation, sick leave, and other time-off categories.
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Rollover Contribution Form
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Comprehensive guide for participants rolling over retirement account balances into the Kroger Savings Plan with specific instructions for direct and indirect rollovers.
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Employee Time Off Request Form
PDF template
A form for employees to request time off for various reasons, subject to employer approval.
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Authorization For Direct Deposit (Form 6186)
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Form for authorizing direct deposit of retirement payments for Sacramento County Employees' Retirement System members.
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TIME OFF REQUEST FORM
PDF template
Detailed guidelines for employees requesting time off and supervisors documenting vacation time
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Tier 2 Retirement Checklist
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Comprehensive checklist for Tier 2 retirement application process, detailing required forms and documentation for pension and benefits
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Special Power Of Attorney
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A legal document allowing appointment of an attorney-in-fact to make retirement-related decisions for a CalPERS member.
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Procedure 4.4.3p. (III.M.I.) Employee Complaint Resolution
PDF template
A formal process for resolving work-related employee complaints within the Technical College System of Georgia, ensuring fair treatment and open communication.
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Application For Group Insurance CHEIBA Trust
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A comprehensive insurance application form for employee group insurance coverage with options for various types of insurance benefits.
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Student Health Information Form
PDF template
Comprehensive health information form for collecting student medical and contact details at a university
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FirstChoice Personal Super Withdrawal Form
PDF template
A form for withdrawing units from a superannuation fund, either as a rollover to another fund or as a cash withdrawal with specific conditions.
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MSDH Motivated To Live A Better Life Referral Form
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A comprehensive referral form for patients seeking health management support through the Mississippi State Department of Health's lifestyle program.
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Section 74(B) Clean Bus Energy Grant
PDF template
A grant program to replace diesel school buses with electric, propane, and compressed natural gas buses to reduce emissions and improve air quality.
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Hazard Report Form
PDF template
A form for documenting workplace safety hazards, their severity, and corrective actions.
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Incident Investigation Form
PDF template
A comprehensive form for documenting workplace incidents, injuries, and required follow-up actions.
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Employee Name Change Form
PDF template
A form for employees to update their name in university payroll and HR systems with required documentation.
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Smedley Fund Contribution Form
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A donation form for contributing to the Toastmasters International Smedley Fund with multiple contribution options and payment methods.
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Vehicle Parking Registration
PDF template
Form for employees to register their vehicles for parking at UWSA (University of Wisconsin System Administration) location.
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Summary Plan Description Bargained Cash Balanced Program 2 Of The ATT Pension Benefit Plan
PDF template
A comprehensive guide to benefits for employees under the Bargained Cash Balance Program #2, detailing pension plan provisions and eligibility.
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Medical History Form
PDF template
Comprehensive medical form for students to provide health history and undergo medical screening for enrollment.
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GROUP PLANS ENROLLMENT FORM
PDF template
Comprehensive form for employees to select and enroll in group insurance and benefit plans covering life, disability, medical, and supplemental insurance options.
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Certificated Resignation Form
PDF template
Official form for Los Angeles Unified School District certificated employees to resign from service, including those retiring through CalSTRS.
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Security Incident Report
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Official form for documenting security incidents at the Mississippi State Department of Health's Office of Health Informatics.
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OneSIPP BeneficiaryS Drawdown Pension Application Form
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Application form for inheriting pension funds and establishing beneficiary drawdown or transferring existing dependent's pension benefits.
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2019 Jijak Youth Camp Medical Release Form
PDF template
A comprehensive medical form for youth camp participants to provide health information, allergies, immunization status, and medical details.
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Employer Affidavit Of Income And Benefits
PDF template
Legal document providing instructions for employers to report an employee's income, benefits, and financial records to assist court proceedings.
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Medical History Form
PDF template
A comprehensive medical history form for sports participation, requiring detailed health information and consent statements.
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California State Income Tax Withholding Form
PDF template
Form for Los Angeles Fire & Police Pension members to elect state income tax withholding options for their pension payments.
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Administrative Policy And Procedures Manual 901 REIMBURSABLE BUSINESS RELATED EXPENSES
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Policy outlining the Judicial Branch's guidelines for employee reimbursement of job-related expenses and travel.
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Emergency Contact Form
PDF template
A document for collecting emergency contact information for employees to ensure quick communication during urgent situations.
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NYCERS Loans Brochure
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Comprehensive guide for New York City Employees' Retirement System (NYCERS) members about pension account loans and eligibility requirements.
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COVID 19 Participant Code Of Conduct And Risk Assessment Form
PDF template
A comprehensive guidance document outlining participant responsibilities and precautions for COVID-19 safety during Special Olympics activities.
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Group Benefits EnrolmentChange Form
PDF template
A comprehensive form for enrolling or changing group benefit plan details for employees, including personal information, coverage selection, and benefit options.
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DOT Physical Examination Form
PDF template
Medical examination form for commercial vehicle drivers to assess physical fitness for driving.
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Advancing Access Patient Information Form
PDF template
Comprehensive form for collecting patient personal information, contact preferences, and insurance details for medical services.
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Benefits Administration Letter 99 101
PDF template
Official guidance from the Office of Personnel Management addressing common documentation problems in Federal Employees Retirement System (FERS) applications and retirement claims.
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A10 Risk Assessment Policy
PDF template
A comprehensive policy outlining the school's approach to identifying and managing health and safety risks for staff, pupils, and visitors.
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Halina Pelczar V. Board Of Review, Department Of Labor, And AE Clothing Corporation
PDF template
Judicial opinion regarding unemployment benefits appeal involving an employee's voluntary job separation
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Nassau Re Trust Ownership QA
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Comprehensive guide addressing key questions about trust-owned annuities and their requirements with Nassau Re.
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457 DEFERRED COMPENSATION PLANS CONTRIBUTION FORM
PDF template
Form for initiating or changing after-tax contributions to a 457 deferred compensation plan through an employer.
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Preparticipation Physical Evaluation Physical Examination Form
PDF template
Medical evaluation form used to assess an athlete's physical fitness and eligibility to participate in sports activities.
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Preparticipation Physical Evaluation Physical Examination Form
PDF template
A comprehensive medical evaluation form for athletes to assess physical fitness and clearance for sports participation.
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Veterans Administration Aid And Attendance Claim Checklist
PDF template
Comprehensive checklist of required documentation for filing a Veterans Administration Aid and Attendance benefit claim, including personal, financial, and military records.
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AAUS Medical Evaluation Of Fitness For Scuba Diving Report
PDF template
A comprehensive medical evaluation form to assess an individual's fitness for scientific scuba diving, including required medical tests and physician's assessment.
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AB13 (VACA) Affidavit For Eligible Veterans Dependents
PDF template
A document outlining tuition exemption requirements for veterans and their dependents at College of the Siskiyous under the Veterans Access, Choice, and Accountability Act.
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Alberta Accident Benefits Initial Claims Process
PDF template
A comprehensive guide for filing insurance claims and accessing medical benefits after an automobile accident in Alberta, Canada.
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MY BENEFIT PLAN BOOKLET
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Comprehensive benefit plan booklet providing counseling and life skills support services for plan members and their dependent children.
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PA ABLE Savings Program Workplace Guide
PDF template
A guide for employers to help employees with disabilities save money through tax-free ABLE accounts with payroll deduction options.
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Contribution Form
PDF template
A form for making financial contributions to an ABLE (Achieving a Better Life Experience) United account for individuals with disabilities.
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Contribution Form
PDF template
A form for contributing money to an ABLE United account, with options for standard and ABLE to Work contributions.
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Payroll Deduction Guide
PDF template
A comprehensive guide explaining how employees can contribute to ABLE United accounts through payroll deductions and the responsibilities of employees, employers, and the Plan.
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Alternate Benefits Program Mandatory Contributions 401(A) Voluntary 403(B) Loan Authorizations
PDF template
Procedure for employees to request and process loans through investment providers using specific authorization steps.
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Direct Deposit Form For NYS Employees
PDF template
Form for New York State employees to set up, modify, or cancel direct deposit bank account information for payroll.
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Academic Affairs Personnel LEAVE REQUEST FORM
PDF template
A comprehensive form for university employees to request various types of leave with multiple approval levels.
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Affordable Care Act (ACA) Health Insurance Payment AUTHORIZATION FOR VOLUNTARY PAYROLL DEDUCTION
PDF template
Authorization form for employees to voluntarily have health insurance premiums deducted from their paycheck under the Affordable Care Act.
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Group Insurance Accelerated Benefit Option Claim Form
PDF template
A form for employees or members to claim an accelerated benefit option for terminal illness life insurance claims.
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Key Electronic Access Request Form
PDF template
A form for requesting building and room access, keys, and electronic entry devices for employees and workers at an organization.
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ERAIDER REQUEST FORM
PDF template
Form for non-TTUHSC employees to request an eRaider account, specifying access requirements and responsibilities.
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AccidentIncident Investigation Safety Guidance Document
PDF template
A comprehensive safety guidance document outlining procedures for investigating and reporting workplace accidents and incidents, including violent or aggressive events.
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Report Of Accident Incident
PDF template
A form for documenting workplace accidents or incidents involving university personnel, students, or workers.
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Accident Injury Report
PDF template
Comprehensive document for reporting and documenting workplace accidents, injuries, and worker's compensation claims.
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Wenatchee School District Accident Prevention Program
PDF template
A comprehensive safety guide for Wenatchee School District employees to prevent workplace accidents and improve occupational safety awareness.
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Accident Report Form For Non Employees
PDF template
A form documenting details of accidents involving non-employees at Chadron State College, used for internal reporting and record-keeping.
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Accident Report Form
PDF template
Comprehensive form for documenting workplace accidents, injuries, and related incident details with personal and organizational information.
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Waubun Ogema White Earth AccidentIncident Report Form
PDF template
A form used to document workplace accidents or incidents, capturing details about the event, potential prevention, and property damage.
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UVU Injury Accident Report Form
PDF template
A comprehensive form for documenting injuries and accidents occurring at Utah Valley University for students, employees, and visitors.
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AccidentIncident Report Form
PDF template
A comprehensive form for documenting workplace accidents or incidents at East Stroudsburg University by employees, students, and visitors.
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City Of Kirkland Accident Report Form
PDF template
A comprehensive form for reporting workplace accidents, injuries, and potential liability claims for City of Kirkland employees.
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Flamstead Pony Club Accident Reporting Protocol
PDF template
Comprehensive protocol for reporting accidents, injuries, and near misses during pony club activities, including documentation requirements and reporting procedures.
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Accident Wellness Benefit Claim Form
PDF template
Insurance claim form for submitting wellness screening benefits and personal health information to Guardian Life Insurance.
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Payroll Cancellation Form ACC PYB001
PDF template
A government form for employees to cancel an existing payroll deduction for the Government of Guam.
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Direct Deposit Form ACC PYD001
PDF template
Form for employees to set up, change, or cancel direct deposit for payroll with the Government of Guam.
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Multi Location Travel Expense Reimbursement Request
PDF template
A comprehensive form for employees and students to request reimbursement for travel-related expenses at North Dakota State University.
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Retirement Contribution Form
PDF template
A form for employers to set up electronic fund transfer (EFT) contributions to employee retirement accounts, specifically 403(b) and other retirement plans.
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ACH Auto Draft Contribution Pre Authorization Form
PDF template
A form allowing church members to set up automatic monthly financial contributions via bank draft.
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Incident Report Form
PDF template
A comprehensive form for reporting various types of incidents involving staff, members, guests, and program participants at the Abilities Centre.
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Extra Effort Award Acknowledgement Of Extra Contribution Form
PDF template
A form to acknowledge and recognize exceptional employee contributions at Southwest Virginia Community College.
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Patient Medical History Form
PDF template
Comprehensive medical history form for collecting patient health information, symptoms, and medical conditions.
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Medical Information
PDF template
A comprehensive medical form collecting personal health details for emergency preparedness at an event or track setting.
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HEALTH ASSESSMENT FORM
PDF template
Confidential form for collecting medical history and potential health needs for students planning to study abroad.
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Patient Intake Form Holistic Health Assessment
PDF template
Confidential questionnaire for determining patient treatment plan and collecting comprehensive medical and personal information.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at Joyanne Kohler Acupuncture, collecting personal and health information.
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Employee Application For Reimbursement Of Expenses Incurred Upon Sale Or Purchase (Or Both) Of Resid
PDF template
Government form for employees to claim reimbursement for relocation-related real estate expenses when changing official work station.
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Documentary Materials RemovalNon Removal Certification And Non Disclosure Agreement
PDF template
A certification document outlining rules for removing or retaining documentary materials when leaving USDA employment.
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AD 3121 Employee Citizenship Form
PDF template
A form used by the U.S. Department of Agriculture to collect employee citizenship and birth information.
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LOCAL 22 HEALTH PLAN DEPENDENT FORM
PDF template
Form for adding a spouse or dependent to the Local 22 Health Plan, requiring personal information and supporting documentation.
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Application To Buy Added Pension CLASSIC, CLASSIC PLUS, PREMIUM
PDF template
A form for employees to apply for additional pension contributions through monthly deductions or lump sum payments
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Application To Buy Added Pension NUVOS Scheme
PDF template
Pension contribution application form for employees to buy additional pension coverage through monthly salary deductions or lump sum payments
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Required NYS School Health Examination Form
PDF template
A comprehensive health examination form for students in New York State, documenting medical history and current health status
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UWS B1242 Accidental Death Dismemberment Insurance
PDF template
Comprehensive employer manual for Accidental Death and Dismemberment insurance policy for University of Wisconsin System employees.
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Change Of Address Form
PDF template
Official form for changing address for New Jersey state pension system members and retirees
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NAMEADDRESSEMERGENCY CONTACT FORM
PDF template
A form for new hires and existing employees to update personal contact and emergency information
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Address Changes
PDF template
Guidelines for updating employee and student addresses in the University's Directory System for payroll, retirement, and insurance correspondence.
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PSC CUNY Welfare Fund Adjunct Enrollment Form
PDF template
Health benefits enrollment form for adjunct faculty members at CUNY with dental and health plan options
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Daemen College Employee Evaluation Instruction
PDF template
A comprehensive performance evaluation form for administrative personnel at Daemen College, detailing assessment criteria and development goals.
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Discrimination Or Harassment Incident Report
PDF template
A formal document for reporting discrimination or harassment incidents within Prince George's County Public Schools by employees or volunteers.
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C911CD Time Off Request Form
PDF template
A standardized form for employees to request time off from work, specifying leave type and duration.
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Administrative Waiver How To Request Waiver For An Overpayment Under 1000
PDF template
Instructions for requesting an administrative waiver for Social Security overpayments less than $1,000.
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Admission Agreement And Health Assessment
PDF template
Comprehensive form for child enrollment, medical history, emergency contacts, and health assessment for childcare or educational settings.
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Adolescent Vaccination Consent Form (TdapTd, HPV, Meningococcal ACWY)
PDF template
A consent form for parents/guardians to authorize vaccination of adolescents for Tdap/Td, HPV, and Meningococcal ACWY vaccines.
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Adoption Assistance Reimbursement Form
PDF template
Form for employees to request reimbursement for qualified adoption expenses through the university's adoption assistance program.
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ALINE Card Enrollment Form
PDF template
Enrollment form for employees to set up direct deposit of wages to an ALINE Card issued by ADP and MB Financial Bank
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Emergency Medical Form ADULT
PDF template
Comprehensive medical authorization and emergency contact form for adult participants in MUMC trips.
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Oklahoma 4 H Youth Development Participant Information Form
PDF template
A comprehensive form for collecting participant health, emergency contact, and medical information for 4-H youth programs and events.
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Adult Confidential Medical Information And Emergency Notification Form
PDF template
Comprehensive medical information and emergency contact form for participants in the 2007 Big Sky Regional Science Bowl
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Adult Medical Release Form
PDF template
Medical release and consent form for adult participants in environmental education program activities, capturing health information and emergency contact details.
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Advanced Illness Benefit Application Form
PDF template
Application form for palliative care through the Advanced Illness Benefit for advanced cancer/oncology care by BEMAS medical aid scheme.
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Advanced Illness Benefit Application Form
PDF template
Application form for palliative care through the Advanced Illness Benefit for advanced cancer/oncology care by Anglovaal Group Medical Scheme.
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APPLICATION FOR ADVANCED LEAVE
PDF template
A form for county employees to request advanced leave due to catastrophic illness or injury for themselves or immediate family members.
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SunAdvantage RRSPTFSA Sponsor Administration Guide
PDF template
A comprehensive guide for small business owners to manage employee retirement and savings plans with minimal administrative burden.
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Medical Information And Physician Release
PDF template
A medical form for documenting participant health status and physician clearance for exercise participation at Oregon State University's Adaptive Exercise Clinic.
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Barton Community College Foundation Contribution Form
PDF template
A donation form for contributing to the Barton Community College Foundation's academic enrichment fund campaign.
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Army Emergency Relief Application For Financial Assistance
PDF template
Comprehensive application form for military personnel seeking emergency financial support from Army Emergency Relief (AER)
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Pension Application Form
PDF template
Application form for pension benefits through the Australian Expatriate Superannuation Fund, designed for expatriate superannuation members.
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AUSTRALIAN ETHICAL SUPER PENSION APPLICATION FORM
PDF template
A comprehensive application form for establishing a pension account or transitioning to retirement with Australian Ethical Super.
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WIGI Bill Residency Affidavit For Children And Spouses Of Eligible 5 Year Veterans
PDF template
Residency verification form for children and spouses of veterans seeking Wisconsin GI Bill educational benefits based on veteran's 5-year state residency.
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Photo ID Application Form
PDF template
A form for obtaining a photo identification badge for employees and affiliates at UCLA Health System and associated schools
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Initial Disability Claim Form
PDF template
Comprehensive form for filing a disability insurance claim covering various types of disability including accidents, sickness, pregnancy, and cancer.
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AFSCME Local 127 PPO Benefits Matrix
PDF template
Comprehensive dental insurance plan detailing coverage levels for various dental treatments and services.
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CONTRIBUTION FORM
PDF template
A form for making financial contributions to the Mississippi State University Foundation with multiple donation and payment options.
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Benefits Committee Meeting Agenda
PDF template
Agenda for a Benefits Committee meeting discussing various benefits-related topics and goals for 2018/2019.
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Benefits Committee Meeting Agenda
PDF template
Agenda for Benefits Committee meeting detailing review of minutes, old and new business items related to employee benefits.
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AGMA Health Fund Retirement Plan Consent To Electronic Delivery
PDF template
A form allowing members to receive AGMA Health Fund and Retirement Plan notices electronically via email.
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AGS Incident Near Miss Hazard Report Form FRM067 010519
PDF template
A workplace safety form for reporting incidents, near misses, hazards, or potential safety concerns within an organization.
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Near Miss Hazard And Incident Reporting Guidelines
PDF template
Comprehensive guidelines for reporting and managing workplace health and safety incidents, near misses, and hazards within an organization.
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High Adventure Activity Medical Form
PDF template
A medical form for certifying individual fitness for high-risk adventure activities for youth organizations.
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AHN Employee Giving Payroll Deduction Form
PDF template
Form for AHN employees to set up charitable contributions through automatic payroll deductions
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Arizona Interscholastic Association Annual Preparticipation Physical Evaluation
PDF template
A comprehensive medical screening form for student-athletes to assess their health and fitness for sports participation.
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AISA Risk Management Program For Local Level Sports
PDF template
Comprehensive guidelines for school sports programs focusing on athlete safety, injury prevention, and risk management protocols.
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Alabama EWIC Vendor Kickoff Meeting
PDF template
Presentation explaining the electronic WIC benefits system for vendors in Alabama, detailing transaction processing and program benefits.
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Alexandria Library Foundation Contribution Form
PDF template
A donation form for contributing financial support to the Alexandria Library Foundation with various contribution level options.
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Preparticipation Physical Evaluation (Interim Guidance) Physical Examination Form
PDF template
A comprehensive medical examination form for athletes to assess physical fitness and health status prior to participation in sports activities.
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LEAVE REQUEST FORM COVID Related
PDF template
A comprehensive form for employees to request leave related to COVID-19 circumstances, covering various scenarios of quarantine, vaccination, and childcare needs.
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Affidavit For Spousal Coverage
PDF template
Form for employees to certify spouse's eligibility for medical plan enrollment at Allegheny College by verifying no alternative employer health coverage.
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Alfred State Workshop AllergyMedical Form
PDF template
A comprehensive medical form for documenting a camper's allergies, medical conditions, and emergency contact information.
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Springfield Platteview Community Schools Health Examination Form
PDF template
A comprehensive health and immunization form for students in kindergarten through 12th grade in Springfield Platteview Community Schools.
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Allied, Therapeutic And Psychology Extender Benefit Application Form For 2024
PDF template
Application form for healthcare benefit coverage under the Retail Medical Scheme's Essential Plus Option for allied, therapeutic, and psychology services.
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TCNJ Faculty And Staff Campaign Payroll Deduction Form
PDF template
A form enabling TCNJ faculty and staff to set up or modify payroll deductions for charitable donations to various campus programs and departments.
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Accident Coverage Claim Form
PDF template
Insurance claim form for reporting accidental injuries and seeking coverage benefits from American Heritage Life Insurance Company.
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Blue Cross Medical Travel Benefit Claim
PDF template
A claim form for medical travel expenses for members of the Arrow Lakes Teachers' Association submitted to Pacific Blue Cross.
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Alternate Work Arrangement Agreement Form
PDF template
A document for employees to request and document flexible work arrangements at Middle Tennessee State University.
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AWL Equipment Inventory
PDF template
A form for documenting university-owned equipment issued to an employee for use at an alternate work location, including equipment tracking and usage agreement.
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AWL Safety Checklist
PDF template
A comprehensive safety checklist for employees working in alternate work locations to ensure workspace safety and security.
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Enrollment Form
PDF template
A comprehensive enrollment form for dental and vision insurance coverage through an employer's benefit plan.
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Enrollment Form
PDF template
A comprehensive form for enrolling in dental insurance coverage, including subscriber and dependent information, coverage options, and coordination of benefits.
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ENROLLMENT FORM VISION ONLY
PDF template
A comprehensive enrollment form for vision insurance coverage, allowing employees to add or modify vision insurance benefits.
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AME Reimbursement Request Form
PDF template
A form for University of Arizona employees and students to request reimbursement for expenses with detailed payee and receipt information.
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Medical Examination Report For Bus Transit System Driver
PDF template
Comprehensive medical examination form for bus transit system drivers to assess health conditions and fitness for duty.
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Enrollment Change Waiver Group Insurance Form
PDF template
Insurance form for enrolling, changing, or waiving group dental insurance coverage for employees and their dependents.
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Claim Form To Pay InsuredSubscriber
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Claim Form To Pay InsuredSubscriber
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Western Carolina University Base Camp Cullowhee Health And Medical Form
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Benefits Cancellation Form
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We CanT Wait Act Of 2023
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Santa Monica College Confidential Medical History
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Patient Medical Referral Form
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North Florida Area Conference (Area 14) Bridging The Gap Volunteer Form
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Brightline Employee Special Offers
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BUILDING HEALTH AND SAFETY RISK ASSESSMENT FORM
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BuildOn Medical Form
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Business Card Order Form
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Business Credit Application Agreement
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Payroll Time And Attendance Form Preparation
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Employee Requisition Form
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Physical Examination Form For Driver Applicant
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Form SSA 634 Request For Change In Overpayment Recovery Rate
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AccidentIncident Investigation Recording Policy
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Opinion Of Trustees ROD Case No. CA 0097
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Payroll Check Direct Deposit Authorization
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CAH Termination Policy
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CalPERS 1008 Direct Payment Authorization
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Special Power Of Attorney
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CalPERS Special Power Of Attorney
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2017 CAL SMAC PAC AUCTION CONTRIBUTION FORM
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Camp Dina Medical Form PhysicianS Page
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Camp Potlatch 2020 Medical Form
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NYC Summer Camp Permitting Application Guidance
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Camp Potlatch 2022 Medical Form
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Payroll Deduction Authorization
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Canada Manitoba Housing Benefit Homelessness Stream Application
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Application for financial housing support for individuals at risk of or experiencing homelessness in Manitoba.
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Request To Cancel Coverage Form
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Miscellaneous Deductions And Insurances Cancellation Form
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Form for cancelling optional insurance plans and miscellaneous deductions not subject to pre-tax restrictions.
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CLAIM FORM AND INSTRUCTIONS
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CANINE EXPORT SUBMISSION FORM
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MEDICAL HISTORY FORM
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Staff Council CARE Award Nomination Form
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Caregiver Medical History Form
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Medical History Form
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Risk Assessment Policy And Procedures
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Catholic Charities Contribution Form
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A payroll form allowing University of Portland employees to initiate or terminate recurring charitable contributions to Catholic Charities.
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Animal Patient Medical Record
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SAP Payroll Time Management Time Entry
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Documentation for recording employee timesheet data in SAP time management system for University of Mississippi departments.
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Program Health And Waiver Form
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Community Benefit Application Form
PDF template
An annual application process for community facilities and small businesses to receive support for community development projects from Sennit Construction.
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CarerS Credit Application Form
PDF template
An application form for individuals providing care to claim Carer's Credit, a National Insurance credit for carers.
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Backflow Incident Report Form
PDF template
A form for reporting water system backflow incidents, detailing contamination sources, effects, and corrective actions.
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Backflow Incident Report Form
PDF template
A form for reporting water supply contamination incidents involving backflow, used to document details of potential water quality hazards.
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CCC Time Off Request Form
PDF template
A form for employees to request time off, including vacation, sick leave, or day-for-day leave for exempt employees.
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Cultural Competency Professional Development (CCPD) Credit By Attendance Form
PDF template
A form for employees to document and request credit for professional development activities related to cultural competency and equity training.
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LEAVE REQUEST CERTIFIED
PDF template
A comprehensive form for employees to request various types of leave, including sick leave, personal leave, and FMLA/OFLA.
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Cottonwood Crossing Summer Institute Health Information Form
PDF template
A comprehensive medical form for student participation in summer institute activities, collecting health insurance, medical history, and emergency treatment authorization.
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Copper Country United Way Contribution Form
PDF template
A form for making charitable donations to Copper Country United Way through various payment methods including cash, payroll deduction, or credit card.
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Safety Committee Policy
PDF template
Policy establishing the formation, membership, and purpose of a safety committee for the Deschutes County Adult Jail to promote workplace safety and health.
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Safety Committee Policy
PDF template
Policy establishing a workplace safety committee for the Deschutes County Adult Jail to promote workplace safety and health through cooperative efforts.
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Pre Employment Medical Form
PDF template
Comprehensive medical assessment form for pre-employment screening including medical history, vital signs, and tuberculosis screening.
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Cell Phone Allowance Cancellation Form
PDF template
A form to cancel cell phone reimbursement for employees of the University of Utah's Payroll Department.
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CEM Employee Travel Authorization Form
PDF template
A form for obtaining departmental approval and documenting travel expenses for employee business trips.
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APPLICATION FOR DISABILITY BENEFIT
PDF template
Application form for disability benefits from the Central States, Southeast and Southwest Areas Pension Fund for eligible participants.
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Central States Pension Fund Retirement Declaration
PDF template
A document for declaring retirement date, employment status, and receiving pension benefits from the Central States Pension Fund.
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Classified Employee Of The Month Nomination Form
PDF template
A form for nominating exceptional classified employees at the College of Southern Nevada for monthly recognition and awards.
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College Of Southern Nevada Classified Employee Of The Month Nomination Form
PDF template
A form to recognize and nominate exceptional classified employees at the College of Southern Nevada for monthly recognition.
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California Employers Retiree Benefit Trust Sub Account Contribution Form
PDF template
A form for making contributions to multiple California Employers' Retiree Benefit Trust sub-accounts for different employee bargaining units.
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Certificated Employee Resignation Form
PDF template
A form for certificated employees of Vacaville Unified School District to resign from their position and document retirement benefits election.
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Certificated Resignation Form
PDF template
A form for certificated employees to resign from their positions, with options for standard resignation or retirement through CalSTRS.
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CERTIFICATION AGREEMENT
PDF template
A certification form for veterans and dependents seeking educational benefits through VA programs at Santa Monica College.
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MEDICAL FORM
PDF template
Confidential medical history form for collecting patient personal and health information for medical examination purposes.
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CFLeads Investment Contribution Form
PDF template
A donation form for supporting CFLeads, allowing organizations to make financial contributions to strengthen community leadership potential.
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The Colorado Freedom Memorial Contribution Form
PDF template
A contribution form for making donations to the Colorado Freedom Memorial Foundation with options for donor privacy and communication preferences.
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PAYROLL DEDUCTION FORM
PDF template
Form for employees to update or initiate payroll deductions for Cat PowerInvestment note investments.
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EMPLOYEE PAID TIME OFF REQUEST FORM
PDF template
A form for CFS SDS employees to request and track paid time-off hours, requiring employee and HR signatures.
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WV Income Maintenance Manual Chapter 2
PDF template
Guidelines for reporting changes and maintaining SNAP (Supplemental Nutrition Assistance Program) case eligibility in West Virginia.
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Accident Investigation Appendix C Resources
PDF template
Guide for reporting and documenting workplace accidents, incidents, and injuries at Portland Community College
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MEDICAL INFORMATION AND RELEASE FORM
PDF template
A comprehensive medical form for participants in Hartwick College Challenge Programs, collecting health information and liability acknowledgment.
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CHAMP Assessment Medical History Form
PDF template
Comprehensive medical history form for fitness assessment program, collecting health and exercise background information from participants.
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ChancellorS Circle Society Membership
PDF template
A form for individuals or businesses to join the Chancellor's Circle Society through an annual membership donation.
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Change Of Address Form
PDF template
A form for updating personal contact information with the Cambridge Retirement System.
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Change Direct Deposit
PDF template
Instructions for changing direct deposit payment method by completing and uploading a form to the Benefits Portal.
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STANDARD CHANGE FORM
PDF template
A form used for updating employee payroll information, deductions, and status for existing employees or new hires.
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GROUP POLICY CHANGE FORM
PDF template
A form for employees to request changes to their group insurance policy details and dependent status.
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Change Of Address Or Name Form
PDF template
A form for TRS members to update personal contact information and address details.
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Change Of Address Form
PDF template
Form for updating personal contact information for 1199SEIU Benefit Funds members.
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NEW ADDRESS CHECKLIST (ACTIVE RETIRED)
PDF template
Guide for active and retired members of the Uniformed Firefighters Association to update their contact information and address.
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Change Of Address Form
PDF template
A form for TRS members to update their personal contact information and address details
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Address Change Request
PDF template
Form for employees to update their contact information in the company's HR system (PeopleSoft)
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Change Of Address Form
PDF template
Official form for employees to update personal contact information and address details with the City University of New York (CUNY) Office of Human Resources.
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Employee Change Of Address Form
PDF template
A form for employees to update their personal contact and address information with their employer.
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Change Of Address For Inactive Members
PDF template
A form for inactive retirement system members to update their contact and mailing information with the Montana Public Employee Retirement Administration.
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CHANGE OF ADDRESS FORM
PDF template
A form for employees to update their mailing address with the Office of Human Resources.
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Change Of Address For Retirees
PDF template
A form for Montana Public Employee Retirement Administration retirees to update their mailing address and contact information.
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Employee Change Of Address Form
PDF template
A form for Puyallup Tribe of Indians employees to update their personal contact and address information with Human Resources.
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Change Of Name And Address Policy
PDF template
Policy outlining the process for employees to update their personal information with the university's Human Resources department within 30 days of changes.
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Change Of Use Request
PDF template
A process for evaluating and approving changes in commercial facility use and determining septic system adequacy in Indiana.
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2020 States 4 H OB Medical Form (Non Japan)
PDF template
Medical evaluation form for chaperones participating in a cross-cultural exchange program, assessing health status and medical conditions.
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VA Form 22 1990 Application For VA Education Benefits
PDF template
Official application form for veterans seeking educational assistance benefits through VA programs like Montgomery GI Bill.
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2024 FSA Enrollment Form
PDF template
Annual enrollment form for flexible spending accounts covering healthcare, limited healthcare, and dependent daycare expenses for the 2024 plan year.
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Request For Charitable Contribution
PDF template
A form for student organizations to request and document charitable donations through agency accounts.
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Charitable Contribution Form
PDF template
A donation form for supporting the UC Santa Barbara's Santa Cruz Island Reserve through financial contributions.
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SUNY Charitable Giving Campaign Deduction Form
PDF template
Form for employees to authorize charitable contributions to SUNY campuses through payroll deductions
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Retirement Checklist
PDF template
Comprehensive checklist for teachers preparing to retire, detailing required documentation and steps to complete before retirement.
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Checklist For ResigningRetiring Employees
PDF template
A comprehensive checklist for employees of the School District of Philadelphia planning to resign or retire, providing guidance on pension and separation procedures.
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Checklist For ResigningRetiring Employees
PDF template
A comprehensive guide for employees of the School District of Philadelphia who are resigning or retiring, outlining required steps and pension processing information.
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Safety Inspection Form For Chemistry Laboratory, Chem CU
PDF template
A comprehensive safety inspection form for evaluating laboratory safety protocols, equipment, and documentation requirements.
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Checklist To Enroll In Retiree Health Insurance
PDF template
Step-by-step instructions for Dutchess County employees enrolling in retiree health insurance and Medicare
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COPERS Change Of Address Form
PDF template
A form for retired city employees to update their contact information with the City of Phoenix Employees' Retirement System.
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Contribution Form
PDF template
A donation form for contributing to Columbus House, a non-profit organization focused on ending homelessness.
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Health Care Provider Exam Form
PDF template
A comprehensive medical examination form for tracking patient vaccinations, health status, and provider details.
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Immunization And Health Assessment Form
PDF template
Medical form documenting vaccination history, physical exam status, and healthcare recommendations for children.
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Idaho Conditional Attendance To Childcare Schedule Of Intended Immunizations Form
PDF template
A form documenting the intended immunization schedule for children not fully vaccinated at childcare admission
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Child Care General Health Examination Form
PDF template
A health examination form for children entering child care programs, documenting their general health status and medical information.
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Child Care General Health Examination Form
PDF template
A medical form documenting a child's health status and conditions for child care program enrollment.
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Child Care General Health Examination Form
PDF template
A medical form documenting a child's health status and conditions for child care enrollment.
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Academic Student Employee (ASE) And Graduate Student Researcher (GSR) Childcare Reimbursement
PDF template
Form for UAW-represented student employees to request reimbursement of eligible childcare expenses at the University of California.
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MEDICAL HISTORY CHILD
PDF template
Comprehensive medical history questionnaire for collecting pediatric health information and previous medical conditions.
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Health Information Form
PDF template
Confidential health information form for participants in an international research program between Alabama A&M University and Nanjing Forestry University.
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STUDENT HEALTH FORM
PDF template
Comprehensive health form for students to provide medical information and health status to an educational institution
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CLIENT REQUISITION FORM
PDF template
A comprehensive medical test requisition form for various health diagnostics including inflammation, lipids, metabolic, and other specialized tests.
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Choice PCA Paid Time Off Request Form
PDF template
A form for Choice PCA employees to request paid time-off from their client, requiring approval and submission to payroll.
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State Contribution Form
PDF template
A donation form for contributing to the California Hospital Association Political Action Committee (CHPAC)
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Chronic Illness Benefit Application Form
PDF template
An application form for patients seeking chronic illness benefits through the Glencore Medical Scheme, detailing submission requirements and contact information.
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Student Loan Repayment Program
PDF template
Official instruction establishing Coast Guard policy for student loan repayment benefits for civilian employees.
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Countermeasures Injury Compensation Program Request For Benefits Form
PDF template
Form for individuals seeking medical and employment benefits after experiencing a serious injury from a covered countermeasure such as vaccines or medical equipment.
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Enrollment Change Form (Consolidated)
PDF template
A comprehensive form for employees to enroll or change health insurance and related benefits with multiple coverage options.
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Medical Claim Form
PDF template
Form for submitting medical claims for fellows, trainees, and patients seeking international health insurance reimbursement.
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CIMERLI Solutions Enrollment Form
PDF template
Comprehensive enrollment form for healthcare services, insurance verification, and patient assistance programs offered by CIMERLI Solutions
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Food Inspection Form
PDF template
Official form used by the Environmental Health Department to conduct food safety inspections of commercial food establishments.
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FAMILY FIRST CORONAVIRUS RESPONSE ACT (FFCRA) OREGON FAMILY LEAVE ACT (OFLA) LEAVE REQUEST FORM
PDF template
A form for employees to request leave under FFCRA and OFLA due to COVID-19 related reasons.
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City Of Takoma Park MD Enrollment And Contribution Form
PDF template
Form for employees to enroll in and contribute to the City of Takoma Park's 457 Deferred Compensation Plan at MissionSquare Retirement.
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Military Connected New Student Checklist
PDF template
A comprehensive guide for military-connected students transitioning to Northern Arizona University (NAU), covering benefit applications and campus resources.
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Military Medical Intake And Deployment Assessment Form
PDF template
Comprehensive medical assessment form for active duty military personnel covering health status, deployment readiness, and substance abuse screening.
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Virginia Workers Compensation Commission Claim Form
PDF template
Official form for filing a workers' compensation claim in Virginia, documenting workplace injury details and requesting benefits.
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CIEE Claim Form
PDF template
A comprehensive medical claim form for student health insurance reimbursement and documentation of medical conditions or treatments.
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Employee Information Checklist
PDF template
A comprehensive checklist evaluating workplace safety, ergonomics, fire safety, electrical safety, and workstation conditions for employees.
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Conference Attendance Report Form
PDF template
Form for classified employees to document conference attendance, learnings, and key insights from professional development events.
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Leave Request Form (5 Days)
PDF template
A form for employees to request extended leave of 5 or more days, to be submitted to Human Resources with supporting documentation.
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LOWER COLUMBIA COLLEGE CLASSIFIED PPE FOOTWEAR PURCHASE FORM
PDF template
A form for employees to request reimbursement or purchase of personal protective equipment (PPE) footwear up to $200 every two years.
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Payroll Deduction Form
PDF template
Form for employees to set up or modify payroll deductions for the Chaffey College Auxiliary Classified Senate account.
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Contribution Form Catastrophic Sick Leave Bank
PDF template
A form for classified employees to voluntarily contribute sick leave days to a shared catastrophic leave bank for extreme circumstances.
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Classified TransferPromotion Request Form
PDF template
A form for employees of Cutler-Orosi Joint Unified School District to request an internal job transfer or promotion.
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CCLLA Classified Leave Application
PDF template
A comprehensive form for employees to request various types of leave, including vacation, sick, FMLA, and flex time adjustments.
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Classified Employee Appraisal Process
PDF template
A comprehensive workflow for conducting performance evaluations for Administrative & Professional and Classified Employees at UTRGV.
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Patient Information Form
PDF template
Comprehensive patient intake form collecting personal, contact, medical, and insurance information for dermatology services.
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Contribution Form
PDF template
A donation form for making financial contributions to the Conservation Law Foundation with options for recurring or one-time gifts.
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Account Holder Authorization And Consent Form
PDF template
A consent form allowing the Department of Community Services and Development to share utility account information for energy assistance program evaluation.
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CLIMBucknell MEDICAL FORM
PDF template
Medical history and emergency contact form for participants in a university climbing/ropes course activity
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2024 2025 Nomination Of Classified Professional
PDF template
Nomination form for classified professionals to participate in a leadership development program within the Chabot - Las Positas Community College District.
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Contribution Form
PDF template
A form for contributing money to an Alabama ABLE account using a check, with specific instructions and limitations.
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Contribution Form
PDF template
A form for contributing money to an ABLE for ALL Savings Plan account using a check, with details about contribution limits and requirements.
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Medical History Form
PDF template
Comprehensive medical history form collecting patient's personal health details, family medical history, and lifestyle information.
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Population Assessment Of Tobacco And Health (PATH) Study Parent Consent And Permission For Youth Int
PDF template
A consent form for parents to allow their children aged 12-17 to participate in a national tobacco and health research study.
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Widow Pension Application
PDF template
A pension application form for widows of cement masons seeking survivor benefits from Local 783 Pension Plan in Houston, Texas.
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Health And Emergency Contact Form
PDF template
A comprehensive form for collecting student medical history, emergency contact details, and healthcare consent at Central Maine Community College.
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PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient demographic, family medical history, and personal health information.
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HEALTH INSURANCE CLAIM FORM
PDF template
Standard medical insurance form for submitting healthcare claims and patient information for reimbursement purposes.
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Health Insurance Claim Form
PDF template
Official form for submitting medical insurance claims and capturing patient and insured party information.
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Medicare Redetermination Request Form 1st Level Of Appeal
PDF template
Official form for Medicare beneficiaries to request a first-level appeal of a Medicare claim determination.
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Medicare Reconsideration Request Form 2nd Level Of Appeal
PDF template
A form for Medicare beneficiaries or providers to request a second-level appeal of a Medicare claim determination.
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Privacy Impact Assessment Benefits Coordination And Recovery Center
PDF template
Privacy impact assessment documenting the data collection and processing system for Medicare benefits coordination and recovery processes.
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CMSP 215 Supplemental Application
PDF template
Application form for individuals seeking medical services coverage through the County Medical Services Program with rights and responsibilities outlined.
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Adult Medical History Form
PDF template
Comprehensive medical history form for collecting patient health information, symptoms, and medical conditions.
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College Of Education And Health Professions ACCIDENTINCIDENT REPORT
PDF template
A comprehensive form for documenting accidents, injuries, and incidents within the College of Education and Health Professions.
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Employee Flexible Spending Account (FSA) Enrollment Form
PDF template
Form for employees to enroll in Flexible Spending Account (FSA) options for healthcare and dependent care expenses.
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Athletics Drug Education And Testing Student Athletes
PDF template
Policy for drug education and testing of student athletes in the Alabama Community College Conference, focusing on health, safety, and fair competition.
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Camp Medical Form, College Tennis Exposure Camp
PDF template
Medical form for participants of a college tennis exposure camp, capturing health history and emergency contact information.
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Account Information Tax Advantage Wellness Programs
PDF template
Form for establishing a new account for Tax Advantage Wellness Programs with Colonial Life insurance services.
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Employee Leave Request Form
PDF template
A comprehensive form for employees to request various types of leave, including annual, sick, FMLA, and other leave types, requiring supervisor and HR approval.
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Colorado State Withholding Certificate For Pension Or Annuity Payments
PDF template
A form for selecting state tax withholding options for monthly pension distributions from the Fire & Police Pension Association.
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CONTRIBUTION FORM
PDF template
Form for making charitable donations through payroll deduction in Washington State's Combined Fund Drive (CFD)
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Combined Safety Inspection Form
PDF template
A comprehensive safety inspection checklist for laboratory environments at Dartmouth College to ensure compliance with safety protocols and regulations.
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Community Membership Form
PDF template
A medical history and liability waiver form for campus recreation membership at Lees-McRae College, requiring personal and medical information along with a hold harmless agreement.
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Wellness Community Membership Form
PDF template
Form for enrolling in NEO Wellness community membership with health information and policy acknowledgment.
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School District Of Philadelphia Community Training Reimbursement Form
PDF template
Form for employees to request reimbursement for educational training expenses and transportation costs within the School District of Philadelphia.
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Complaint Documentation Form
PDF template
A comprehensive form for documenting and investigating employee complaints, including initial reporting, meeting details, and investigation procedures.
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Complaint Report
PDF template
A form for submitting complaints to the local health department, allowing individuals to report health or nuisance-related issues.
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COQUILLE SCHOOL DIST. COMPENSATION PRE AUTHORIZATION
PDF template
A form for employees to request and receive pre-authorization for extra work hours and compensation
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Concussion Incident Form
PDF template
A form for documenting and reporting concussion-related incidents in sports, specifically for Ringette Canada.
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Concussion Recovery Teacher Feedback Form
PDF template
A form for teachers to provide feedback on a student's post-concussion academic performance and symptoms.
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Concussion Waiver Form
PDF template
A waiver form for student athletes acknowledging their responsibility to report concussion symptoms and potential injuries.
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Concussion Waiver Form
PDF template
A waiver form requiring student athletes to acknowledge their responsibility in reporting concussion symptoms and understanding concussion risks.
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ConferenceTravel Pre Approval Form
PDF template
A form for employees to request pre-approval for conference or travel expenses with detailed cost estimation and reimbursement guidelines.
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Confidential Employee Evaluation Process
PDF template
A comprehensive document outlining the performance evaluation procedures and process for employees at Victor Valley Community College District.
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CONFIDENTIALSUPERVISORY EMPLOYEES ABSENCE REPORT FORM
PDF template
A form for reporting employee absences, specifically detailing bereavement leave policies for supervisory employees.
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Environmental Health Safety Policy
PDF template
Policy addressing safety procedures and requirements for entering confined spaces at Connecticut College, following OSHA guidelines.
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Neighborhood Council Funding Contribution Form Fiscal Year 2019 2020
PDF template
A form for neighborhood councils to request funding contributions for special accounts in Los Angeles.
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Neighborhood Council Funding Contribution Form
PDF template
A form for neighborhood councils to request funding contributions for the LA Congress of Neighborhoods Special Account during fiscal year 2020-2021.
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Participant Consent Form
PDF template
A consent form for participants of a workshop, explaining survey data collection and potential Medicare study participation.
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Child Consent Form
PDF template
A comprehensive health screening form for children to assess medical history and vaccination readiness.
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Consent Form ImPACT Baseline Concussion Testing
PDF template
A consent form for participating in baseline concussion testing for student-athletes in Montgomery County Public Schools.
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Utah State Board Of Education ParentGuardian Consent Form Maturation Instruction
PDF template
A parental consent form for students participating in puberty and reproductive health education classes in Utah schools.
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Consentimiento Para Recibir Tratamiento, Cesin De Beneficios Y Garanta De Pago
PDF template
A Spanish-language medical consent and insurance benefits assignment form for Northwell Health Dental Medicine patients.
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Electronic Consent For W 2 Tax Form And 1095S Health Insurance Offer And Coverage Statement
PDF template
Step-by-step guide for employees to provide electronic consent for receiving W-2 and 1095-C tax and health insurance forms online
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Contact Information And Medical Form
PDF template
A comprehensive medical form collecting participant's personal information, emergency contacts, medical history, and health conditions for University of Maine at Presque Isle program participation.
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Federal RetireeS Master Contact List
PDF template
Comprehensive contact list for federal retirees to manage benefits, services, and important resources.
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Contribution Form
PDF template
A donation form for making financial contributions to Manna House, Inc., a non-profit organization located in Baltimore, Maryland.
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Determining EmployeeContractor Status
PDF template
A document used to assess and determine the worker classification status for tax and employment purposes.
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Environmental Health And Safety Contractor Incident Report
PDF template
A comprehensive form documenting workplace incidents, injuries, and safety-related events for contractors.
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Contract Details Register
PDF template
Compilation of multiple IT, services, and procurement contracts with details of suppliers, dates, and values.
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Enrollment And Contribution Form
PDF template
A form for employees to enroll in or modify contributions to a 457 deferred compensation retirement plan.
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Payroll Deduct Roth IRA Contribution Form
PDF template
Form for employees to authorize payroll deductions for Roth IRA contributions with specific contribution limits and guidelines.
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Contribution Confirmation Form
PDF template
A donation form for supporting Warren Village's family services and early learning center through tax-deductible contributions.
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Alumni News Update Submission Form
PDF template
A form for alumni to update personal and professional information and make voluntary contributions to the Jackson School of Geosciences.
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Contribution Form
PDF template
A form for making financial contributions to various programs and funds at College of Marin
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Contribution Form
PDF template
A donation form for contributing financial support to the Guy Harvey Foundation, with options for specifying gift amount and designation.
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Contribution Form
PDF template
A form for making tax-deductible contributions to support the Saint Paul Conservatory for Performing Artists
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Contribution Form
PDF template
A donation form for contributing to various scholarship and research funds managed by the Texas Business and Professional Women's Foundation.
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Account No. Contribution Form
PDF template
A form for making contributions to various types of retirement and investment accounts with multiple contribution methods.
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Contribution Form Building Service 32BJ Supplemental Retirement Savings Plan
PDF template
A form for employees to start, change, or stop pre-tax contributions to a supplemental retirement savings plan
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McLaren Flint Foundation Contribution Form
PDF template
Fundraising form for making charitable donations to McLaren Flint Foundation with multiple designated giving options.
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Seventh Tradition Contribution Form
PDF template
A donation form for individuals, groups, or events to contribute to S-Anon International Family Groups, Inc.
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Truman State University Contribution Form
PDF template
A detailed form for making financial contributions to various Truman State University funds and programs.
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Contribution Form
PDF template
Comprehensive form for making contributions to various retirement and investment accounts including IRA, SEP, SIMPLE, and 401(k)
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Contribution Form
PDF template
Donation form for collecting financial contributions to support the New York Landmarks Conservancy, a non-profit organization.
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Contribution Form
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A donation form for making financial contributions to the Society of Biblical Literature through various payment methods and gift designations.
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Lock Out Contribution Form
PDF template
A form for making financial contributions to support Boilermaker Lodge 146 members locked out by CESSCO Fabrication Engineering Limited.
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CONTRIBUTORY PENSIONGRATUITY APPLICATION FORM
PDF template
An official form for individuals applying for contributory pension benefits in Bermuda, to be submitted within 13 weeks of eligibility.
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Request For Group Life Conversion Materials
PDF template
Form for obtaining individual life insurance policy after group coverage cessation or reduction
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ING Premier Disability Cancellation Form
PDF template
A form for employees to cancel their ING Premier Short Term Disability insurance policy and associated payroll premium deduction.
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Time Off Request Form
PDF template
A form for employees to request and track time off hours across two weeks.
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COVID 19 Incident Report Form
PDF template
A form to document and track potential COVID-19 exposure and incidents among employees.
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Corps Of Cadets Preparticipation Physical Evaluation Medical History
PDF template
Medical history and health evaluation form required for admission to the Texas A&M Corps of Cadets, verifying medical fitness for cadet program participation.
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Contribution Form
PDF template
A donation form for contributing to various funds of the Order of the Daughters of the King organization
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Corrective And Disciplinary Action Form
PDF template
A formal document used to record workplace misconduct, performance issues, and potential disciplinary actions for employees.
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Employee Counseling Action Form
PDF template
A formal document for documenting employee performance issues, counseling actions, and potential consequences.
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NEW YORK STATE TRAVELER HEALTH FORM
PDF template
A required form for individuals entering New York from non-contiguous states, territories, or countries, capturing traveler health and contact information.
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Things To Think About From A Benefits Perspective During The COVID 19 Pandemic
PDF template
A document outlining COVID-19 test reimbursement, free test kit options, and virtual care services for MUSC Health Plan members.
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Mennonite Village Covid 19 Earned Leave Request Form
PDF template
A form for employees to request sick or personal days related to COVID-19 circumstances
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Emergency Leave Request Form
PDF template
A form for employees to request emergency leave related to COVID-19 circumstances and workplace absences.
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COVID 19 Employee Report Form
PDF template
A form for employees to report COVID-19 positive tests or symptoms, used by Wichita State University for tracking and workplace safety purposes.
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Paid COVID 19 Leave Request Form
PDF template
A form for Minnesota executive branch employees to request paid leave related to COVID-19 circumstances under Executive Order 20-07.
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FFCRA 2021 PAID LEAVE REQUEST FORM
PDF template
Form for employees to request paid leave under the Families First Coronavirus Response Act (FFCRA) provisions
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COVID 19 Leave Request Form
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Form for Kansas Department of Transportation employees to request leave related to COVID-19 exposure or symptoms
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COVID 19 Case Interview Form
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A detailed medical form used by the Florida Department of Health to collect information about COVID-19 cases and patient symptoms.
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Employee COVID 19 Leave Request Form
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Form for employees to request leave related to COVID-19 circumstances, including medical diagnosis, quarantine, or childcare needs.
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COVID 19 LEAVE REQUEST FORM
PDF template
A form for employees to request leave related to COVID-19 situations, including quarantine, illness, and childcare needs.
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COVID 19 Leave Request Form
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Form for employees to request leave related to COVID-19 circumstances, including quarantine, household exposure, and vulnerable health status.
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COVID 19 Testing And Symptom Assessment For New Enrolled Student(S) From Out Of CountryState AndOr C
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A health screening form for students to assess COVID-19 symptoms and testing status before school enrollment or return from travel.
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Medical Information Request Form For COVID 19 Temporary Reasonable Accommodation For Faculty, Admini
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Form for Fordham University employees to request workplace accommodations related to COVID-19 high-risk medical conditions
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REQUEST FOR COVID 19 LEAVE
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A form for Miami-Dade County employees to request paid sick leave related to COVID-19 reasons and circumstances.
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COVID 19 Participant Code Of Conduct And Risk Assessment Form
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Comprehensive safety guidelines and risk acknowledgment for Special Olympics participants during the COVID-19 pandemic.
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COVID 19 PERSONAL HEALTH RISK ASSESSMENT FORM
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A comprehensive form to assess individual health risks and COVID-19 exposure for meeting participation and travel to Italy.
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DOH COVID 19 Vaccination Consent Form
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A comprehensive form for collecting patient information and screening for COVID-19 vaccination eligibility.
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Risk Assessment Form For COVID 19 Contact
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A form for documenting potential COVID-19 exposure and health status for university students and staff.
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Communicable Disease Related Hold Harmless, Release, Waiver Of Liability, And Indemnity Agreement
PDF template
Legal document releasing event organizers from liability related to potential communicable disease exposure during an event.
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Families First Coronavirus Response Act Emergency Paid Sick Leave Request Form
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A form for Logan City School District employees to request emergency paid sick leave under the Families First Coronavirus Response Act for COVID-19 related reasons.
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WESTFIELD PUBLIC SCHOOLS COVID 19 SICK LEAVE FORM
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Form for employees to request COVID-19 related sick leave, detailing qualifying reasons for leave under Massachusetts emergency regulations.
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COVID 19 SICK LEAVE FORM
PDF template
A form for employees to request COVID-19 related sick leave under Massachusetts temporary emergency regulations.
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Request For COVID 19 Employer Paid Leave Of Absence
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A form for employees to request paid leave related to COVID-19 circumstances including personal illness, vaccination, or childcare needs.
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COVID 19 Leave Request
PDF template
A form for employees to request leave due to COVID-19 infection, requiring documentation of a positive test and HR verification.
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COVID 19 SUPPLEMENTAL PAID SICK LEAVE REQUEST FORM
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A form for employees to request supplemental paid sick leave related to COVID-19 vaccination, quarantine, or family care needs.
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PARENTALGUARDIAN, SCOUT, LEADER COVID 19 ACKNOWLEDGEMENT CONSENT WAIVER FORM
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A waiver form acknowledging COVID-19 risks for scout activities and granting permission for participation during the pandemic.
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Medical Form For Campers
PDF template
A comprehensive medical form for documenting a camper's health status, medical history, and physical examination details for participation in Camp Promise/Jett Foundation programs.
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KSU Campus Employee Registration Form
PDF template
Registration form for KSU campus employees to request permission to attend a professional education course with supervisory approval.
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Direct Deposit Request
PDF template
A form for employees to set up or cancel direct deposit banking information for payroll purposes.
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Juror Attendance Form
PDF template
Form for LANL employees to document and verify jury duty service for payroll purposes.
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Payroll Deduction Authorization Zia Credit Union
PDF template
Authorization form for employees to set up, change, or cancel payroll deductions to Zia Credit Union
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Physical Examination Form
PDF template
Comprehensive medical examination form for assessing physical fitness, likely for occupational certification purposes.
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Tabor College Contribution Form
PDF template
A form for making financial contributions to Tabor College through credit card or electronic funds transfer.
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Credit Card Payment Authorization Form
PDF template
A form for donors to authorize one-time or recurring credit card payments for charitable contributions
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Crisis Leave Request Form
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A form allowing employees to request leave from a Crisis Leave Pool for personal or family health conditions or extraordinary personal crises.
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CROSS ACT 2020 TIMESHEET
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A document for tracking employee work hours, time worked, and payment details for record-keeping and payroll purposes.
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Contribution Form
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A form for making financial contributions to the Center for Strategic and Budgetary Assessments (CSBA), a non-profit organization focused on national security strategy.
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CSUCI ALTERNATE WORK SCHEDULE PROGRAM APPROVAL FORM
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A form documenting employee request and approval for a 9/80 alternative work schedule at California State University Channel Islands.
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List Of Items Returned By The Employee
PDF template
A comprehensive form for documenting the return of university-owned equipment and assets by an employee upon separation or leaving the institution.
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Colorado State University Pueblo Event ParticipationMedical Form
PDF template
Comprehensive medical form for capturing participant health information, emergency contacts, and medical history for Colorado State University Pueblo events.
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SEPARATING ATTENDANCE FORM
PDF template
A form used by California State University, San Bernardino for tracking employee separation details and final attendance records.
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Commitment To Excellence Award 2024 Nomination Form
PDF template
Award nomination form recognizing outstanding university staff and administrators who demonstrate exceptional commitment and performance.
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Employee Performance Evaluation Form
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Annual performance evaluation documenting goals, objectives, and performance dimensions for an Internal Medicine Account Assistant
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Clerical And Technical Performance Feedback
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A comprehensive form for assessing employee performance across multiple dimensions including communication, customer service, dependability, and technical skills.
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SHORT TERM DISABILITY CLAIM FORM
PDF template
Form for employees to file a claim for short-term disability benefits, including personal and employment details.
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Dependent Care Reimbursement Form
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Form for submitting out-of-pocket dependent care expenses for reimbursement through Peak1 benefits program.
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Custodial Department Time Off Request Form
PDF template
A form for Gundersen Facilities Services employees to request time off for various leave types.
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Short Tissue Repository Research Consent Form
PDF template
Consent form for patients to participate in a genetic research biorepository studying cardiovascular health and disease factors.
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CVS Caremark Prescription Benefits Guide
PDF template
A guide providing six strategies for saving money and time on prescription medications through CVS Caremark's pharmacy benefits program.
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Unemployment Insurance Benefits Referral Form
PDF template
A California state form requiring individuals to apply for Unemployment Insurance Benefits before becoming eligible for CalWORKs.
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2011 OPSEU Time Off Request Form
PDF template
A comprehensive form for employees to request vacation time during different periods, including prime time summer, non-prime time, and holiday periods.
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RCUH Form D 3
PDF template
A comprehensive form documenting employee separation from the Research Corporation of the University of Hawai'i, covering voluntary resignation and involuntary termination details.
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Salary AssignmentCancellation (Form D 60)
PDF template
Detailed instructions for completing a salary assignment or cancellation form for University of Hawaii employees
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Families First Coronavirus Response Act Leave Request Form
PDF template
Form for Kansas state employees to request leave under FFCRA for COVID-19 related reasons
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Medical Form Requirements
PDF template
Comprehensive guide for medical form requirements for Boy Scouts of America camps and activities in Colorado.
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Daily Safety Inspection Form
PDF template
A comprehensive form for documenting employee personal protective equipment (PPE) and safety gear compliance during workplace inspections.
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MEDICAL INQUIRY FORM IN RESPONSE TO AN ACCOMMODATION REQUEST
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A medical form used to assess an employee's disability status and potential need for workplace accommodations under the Americans with Disabilities Act (ADA).
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HR Records Administration Data Verification Request Form
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A form for collecting comprehensive personal and organizational information for HR record-keeping at the University of Alabama at Birmingham.
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Direct Reimbursement Claim Form
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A form for requesting reimbursement from Davis Vision for out-of-network vision services and eyewear expenses.
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Compensation Policy
PDF template
A comprehensive policy outlining compensation principles, employment classifications, and contractor relationship criteria.
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DB 450 Notice And Proof Of Claim For Disability Benefits
PDF template
Instructions for filing a disability benefits claim in New York State, detailing submission requirements and process for employees and recently unemployed individuals.
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New York State Disability Benefits Rights Statement
PDF template
Informational document outlining disability benefits rights for employees in New York State under Section 229 of the Disability and Paid Family Leave Benefits Law.
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Employment Contact Form
PDF template
Form for tracking employment contacts and job search activities for retirement system participants.
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DCBS Superhero Award Nomination Form
PDF template
A form to nominate DCBS employees for recognition based on exemplary professional qualities and performance.
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Duquesne Club Charitable Foundation Contribution Form
PDF template
A form for making tax-deductible donations to the Duquesne Club Charitable Foundation with multiple giving options and fund designations.
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OVERTIME REQUEST FORM
PDF template
A form for employees to request and receive supervisor approval for overtime work hours.
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Title 32 Employee Benefits Part VII Public Employee Deferred Compensation
PDF template
Comprehensive definitions for Louisiana's public employee deferred compensation plan, detailing account balances, administrators, beneficiaries, and related terms.
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DD FORM 1617 Department Of Defense Transportation Agreement
PDF template
Official Department of Defense form establishing government service requirements and transportation allowances for civilian employees transferring outside the continental United States.
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DD FORM 1618, DEC 2023
PDF template
A Department of Defense form establishing government time in service requirements for travel and transportation allowances for civilian employees transferring within CONUS.
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DD FORM 2656
PDF template
A military form for establishing retired pay accounts, beneficiary designations, and Survivor Benefit Plan elections for military personnel.
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DIRECT DEPOSIT CANCELLATION REQUEST FORM
PDF template
Form for employees to cancel their existing direct deposit banking information for payroll purposes at UNC Greensboro.
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Direct Deposit Cancellation Form
PDF template
A form used by employees to cancel their existing direct deposit payroll arrangements with Johns Hopkins institutions.
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VA Fiduciary Hub Financial Institution Information Form
PDF template
A document for veterans' fiduciaries to establish or update direct deposit and account titling with the Department of Veterans Affairs.
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Affidavit To Request Replacement Of SNAP Benefits
PDF template
Form for requesting replacement of SNAP benefits lost due to household misfortune or electronic benefit theft in Oregon.
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Claim For Disability Insurance (DI) Benefits
PDF template
Authorization form for releasing medical information to process a disability insurance claim with the California Employment Development Department (EDD).
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EmployeeS Withholding Allowance Certificate (DE 4)
PDF template
A form for employees to specify their state income tax withholding allowances and exemption status for California tax purposes.
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Employee Incident Investigation Form
PDF template
A formal documentation of an incident involving workplace interactions and potential inappropriate conduct between an employee and her supervisor.
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DEATH BENEFIT APPLICATION FORM
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A form for processing retirement and terminal benefits for deceased retirement savings account (RSA) holders and their next of kin.
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Death Benefit Application Form
PDF template
A form for Fiji Bank & Finance Sector Employees Union members to apply for death benefits for themselves or eligible family members.
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PARKING DECAL REFUND REQUEST
PDF template
A form for employees or students to request a refund for parking decals at Southern Illinois University Carbondale under specific conditions.
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Diver Medical Questionnaire Additional Declarations COVID 19
PDF template
A medical questionnaire and health declaration form for divers to assess fitness and COVID-19 risk prior to participating in diving activities.
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Decrease Election Form For Supplemental Life Insurance
PDF template
A form for active state employees to reduce their supplemental life insurance coverage in prescribed increments.
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Payroll Deduction Cancellation Form
PDF template
A form allowing employees to cancel specific payroll deductions at Western Michigan University.
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Payroll Deduction Cancellation Form
PDF template
Form for employees to cancel various payroll deductions for insurance, benefits, and voluntary contributions.
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COMPENSATION AND BENEFITS TRAVEL REIMBURSEMENT
PDF template
Procedures and guidelines for travel expense reimbursement for employees, volunteers, and other individuals traveling on College business.
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STATE EMPLOYEES DEFERRED COMPENSATION PLAN ENROLLMENT FORM
PDF template
Official form for Illinois state employees to enroll in or modify their deferred compensation retirement plan contributions and investment selections.
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STATE OF VERMONT STATE EMPLOYEE DEFERRED COMPENSATION PLAN EMPLOYEE REQUEST FOR PAYROLL DEDUCTION
PDF template
Form for Vermont state employees to request payroll deductions for a retirement investment program under Section 457(b)
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DEFINED BENEFIT PLAN BENEFICIARY NOMINATION FORM
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Legal document for nominating beneficiaries for a defined benefit pension plan through the State Employees' Retirement System (SERS)
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DEFINED BENEFIT PLAN CHANGE OF ADDRESS FORM
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A form for SERS members to update their mailing address for retirement benefits communication.
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Defined Contribution Plan Division Form
PDF template
A legal document used to divide retirement plan assets during divorce or legal separation proceedings, capturing plan and participant details for asset division.
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Designated Eligible Individual (DEI) Enrollment Form 2024
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Form for Michigan Tech employees to enroll a non-spouse individual for health coverage under specific eligibility criteria.
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Delta Dental EnrollmentChange Form
PDF template
A comprehensive form for enrolling in or modifying dental insurance coverage with Delta Dental plans
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Delta Dental Of Minnesota Membership Enrollment Form
PDF template
Membership enrollment form for Delta Dental insurance coverage, allowing employees to select dental plan options and enroll dependents.
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UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS PRESTON LEE DENT V. ROBERT A. MCDONALD
PDF template
Legal document detailing an appeal regarding the overpayment of non-service-connected pension benefits and the effective dates of benefit reduction.
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Oral Health Assessment Form
PDF template
California-mandated form for documenting children's dental health screenings required before first year of public school.
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ADA Dental Claim Form Instructions
PDF template
Comprehensive instructions for completing the ADA Dental Claim Form, including general instructions, coordination of benefits, and National Provider Identifier requirements.
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Delta Dental Of Wisconsin EnrollmentChangeWaiver Form Dental
PDF template
A form for enrolling in, changing, or waiving dental insurance coverage through an employer's group plan with Delta Dental of Wisconsin.
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COBRA Dental Insurance EnrollmentWaiver Form
PDF template
A form for employees to enroll in or waive dental insurance coverage, with options for adding or dropping dependent coverage under COBRA.
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Dental Insurance EnrollmentWaiver Form
PDF template
A comprehensive form for employees to enroll or waive dental insurance coverage, including personal and dependent information.
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Employee Enrollment Form
PDF template
Comprehensive form for employee insurance enrollment with personal information and coverage details.
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Proof Of School Dental Examination Form
PDF template
State of Illinois form documenting mandatory dental examination for school children in specific grade levels.
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Proof Of School Dental Examination Form
PDF template
A mandatory dental health examination form for students in specific school grades in Illinois, documenting their oral health status.
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Proof Of School Dental Examination Form
PDF template
Official form documenting student dental health examination for Illinois school children in specific grade levels as required by state law.
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Proof Of School Dental Examination Form
PDF template
Official document requiring dental examination for students in specific school grades, documenting oral health status and screenings.
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Kentucky Dental ScreeningExamination Form For School Entry
PDF template
Official form for documenting dental screening or examination required for school entry in Kentucky for five or six-year-old students.
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Proof Of School Dental Examination Form
PDF template
Official form for documenting a student's dental health examination required for school enrollment in Illinois.
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Dental Examination Waiver Form
PDF template
A form for parents or guardians to request a waiver for required dental examinations for students in Illinois schools.
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Dental Examination Waiver Form
PDF template
A form for parents/guardians to request a waiver from required dental examination for school-enrolled children in Illinois.
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Dental Examination Waiver Form
PDF template
A form allowing parents/guardians to request a waiver for required dental examinations for students due to specific insurance or access constraints.
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Dental Insurance EnrollmentChange Form
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A form for employees to enroll in or modify dental insurance coverage, including dependent information and policy details.
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Proof Of School Dental Examination Form
PDF template
Official state form documenting dental health examination for school-aged children in Illinois, mandated by state law for specific grade levels.
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PROOF OF DENTAL EXAM
PDF template
An official dental examination form for students, documenting oral health status and treatment needs.
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Dental Waiver Form
PDF template
A form allowing civil service staff to waive enrollment in Genesee Community College's group dental insurance plan.
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PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive medical and dental history form for patient intake, collecting personal health information and current medical status.
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Kentucky Dental ScreeningExamination Form For School Entry
PDF template
A mandatory dental health screening form for children entering public school in Kentucky, documenting dental health status and examination details.
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DentalVision Enrollment Form
PDF template
Detailed guide for completing a dental and vision insurance enrollment form with step-by-step instructions.
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Medical History Form
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Comprehensive medical history form collecting personal health information, medical background, and current health status.
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Climate Health WA Inquiry
PDF template
Submission by Department of Local Government, Sport and Cultural Industries addressing climate change health impacts in Western Australia
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LEAVE REQUEST FORM
PDF template
A comprehensive form for employees to request various types of leave, including medical, personal, and family leave.
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LEAVE REQUEST FORM
PDF template
A comprehensive form for employees to request various types of leave, including medical, personal, and family leave.
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Health Insurance Enrollment Form
PDF template
A comprehensive form for active employees to enroll in health insurance plans, select medical providers, and manage flexible spending accounts.
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DependantS Pension Application Form
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A form for Nestl European Pension Fund members to nominate a financial dependent to receive pension benefits in the event of the member's death.
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Dependent Audit Form
PDF template
A form for employees to verify and update dependent insurance coverage information and personal details.
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DEPENDENT CHILD CERTIFICATION
PDF template
Form for certifying dependent child eligibility for Texas Employees Group Benefits Program, with multiple certification options based on child relationship and tax claiming status.
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State Of Alaska Payroll Direct Deposit Form
PDF template
A form for Alaska state employees to set up or modify direct deposit arrangements for net pay and flat amount deposits.
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Physics And Astronomy Employee Business Expense Reimbursement Form
PDF template
Guidelines for submitting expense reimbursement forms for Physics and Astronomy department employees using a new electronic process through Workday Expenses.
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Departmental Software Order Form
PDF template
A form for ordering and tracking software licenses and media for Virginia Polytechnic Institute and State University departments.
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Dermatology Medical History
PDF template
Comprehensive medical history form for dermatology patients to document health conditions, medications, and allergies.
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Service Credit Purchase
PDF template
A comprehensive guide for Denver employees about purchasing service credit to enhance retirement benefits through the Denver Employees Retirement Plan.
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EmployeeS Withholding Certificate For City Of Detroit Income Tax
PDF template
Tax withholding form for employees working in Detroit, used to determine income tax exemptions and work locations.
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DFS 405 Onsite Sewage Agency Referral Form
PDF template
Official form documenting the evaluation of a property's suitability for onsite sewage disposal systems in Kentucky.
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CONSENT FORM CONFIDENTIAL HUMAN IMMUNODEFICIENCY VIRUS (HIV) TEST Non Health Care Settings
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Official consent form for HIV testing in non-healthcare settings, documenting informed consent and explaining testing procedures.
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DHA Form 131, TRICARE Prime Travel BenefitCombat Related Disability Travel Patient Information Works
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Form for documenting specialty care and non-medical attendant travel requirements for TRICARE Prime enrollees.
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Patient Medical History Form
PDF template
Comprehensive medical history form for collecting patient personal information, contact details, and health status.
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DHS 2240 Change Report
PDF template
A form used to report changes in household composition, income, and other key life events within 10 days of occurrence.
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Type 2 Diabetes Risk Assessment Form
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A screening tool to evaluate an individual's risk factors for developing type 2 diabetes through a points-based assessment.
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Student Record Card 6
PDF template
A health record and immunization documentation form required for student enrollment in Montgomery County Public Schools in Maryland.
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UDENYCA Solutions Enrollment Form
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Enrollment form for patients seeking information about UDENYCA medication and insurance verification services.
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Veterans Certification Request (VCR)
PDF template
A form for veterans and military-affiliated students to request educational benefits and certification at Southeastern Louisiana University
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COPERS Direct Deposit Form
PDF template
A form for Phoenix city employees to set up direct deposit for their pension checks with banking details and authorization.
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Direct Deposit Form
PDF template
A form for Navajo Nation employees to set up or modify direct deposit banking information for payroll purposes.
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Direct Deposit Authorization And Cancellation Form
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A form for employees to set up, change, or cancel direct deposit banking information with Kaleida Health.
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Payroll Direct Deposit Form
PDF template
Form for employees to set up or modify direct deposit payroll payments at Hope College.
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M NCPPC Direct Deposit Form
PDF template
A form for Maryland-National Capital Park and Planning Commission employees to set up or modify direct deposit banking information for payroll.
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Direct Deposit Authorization Form
PDF template
Form authorizing automatic deposits and withdrawals to an employee's bank account by The University of the South.
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COVA Direct Deposit Form Directions
PDF template
Comprehensive guide for employees completing a direct deposit form, detailing required fields and submission process for the Commonwealth of Virginia payroll system.
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COVA Direct Deposit Form Instructions
PDF template
Instructions for completing a direct deposit form for employees, covering required fields and submission guidelines.
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Direct Deposit Authorization Manual Claim Reimbursement
PDF template
A form allowing employees to authorize direct deposit of claim reimbursements into a checking or savings account.
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Direct Deposit Form
PDF template
A form for employees to set up, modify, or cancel direct deposit of their payroll earnings with their financial institution.
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COVA Direct Deposit Form
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Guidelines for completing a direct deposit form for Commonwealth of Virginia employees, detailing required information and submission process.
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COVA Direct Deposit Form Instructions
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Detailed instructions for employees and agencies completing a direct deposit form for payroll purposes.
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Direct Deposit Information And Instructions
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A form for electing electronic funds transfer for payments from Wespath, a general agency of The United Methodist Church.
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CITY OF KAUKAUNA DIRECT DEPOSIT FORM
PDF template
A form for employees to set up direct deposit of their paycheck into one or multiple bank accounts.
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Direct Deposit Authorization Form
PDF template
A form allowing employees to authorize direct deposit of their paycheck into one or more bank accounts.
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Payroll Direct Deposit Form
PDF template
Form authorizing direct deposit of employee payroll payments for West Virginia University employees
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Direct Deposit Authorization Form
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A form authorizing electronic transmission of payroll funds to an employee's bank account at Widener University.
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Authorization For Direct Deposit Of Retirement Payment
PDF template
Form for setting up direct deposit of retirement payments from the City of Cincinnati Retirement System
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Hollins UniversityADP Direct Deposit Authorization Form
PDF template
A form for Hollins University employees and students to set up or modify direct deposit banking information for payroll and reimbursements.
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Direct Deposit Form
PDF template
Form for Los Angeles Fire & Police Pension members to establish, change, or cancel direct deposit of pension payments.
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Vanderbilt University Direct Deposit Authorization Form
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A form authorizing Vanderbilt University to deposit payroll funds into specified bank accounts
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Direct Deposit Form
PDF template
Form for employees to authorize direct deposit of flexible spending reimbursements through Auxiant.
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City Of Austin Employees Retirement System Direct Deposit Form
PDF template
Form for retired City of Austin employees to set up electronic monthly annuity payments to a chosen financial institution.
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Authorization For Direct Deposit
PDF template
Form authorizing City of Boise employees to set up direct deposit for wage payments and reimbursements.
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SBCERS Direct Deposit Authorization
PDF template
Form for authorizing direct deposit of retirement allowance with Santa Barbara County Employees' Retirement System
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Direct Deposit Form
PDF template
A form for employees to set up direct deposit of payroll checks with their employer and financial institution.
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Direct Deposit Authorization Form
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A form for setting up electronic funds transfer for NEBF benefit payments to a participant's bank account.
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Direct Deposit Authorization Form
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Form for employees to provide banking details for payroll direct deposit at Blue Ridge Community College.
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Direct Deposit Employee Authorization Form
PDF template
A form for employees to authorize automatic payroll deposits into bank accounts, including options for new, changed, or additional deposits.
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SPLLC Direct Deposit Form
PDF template
Form for employees to provide bank account details for direct deposit of payroll earnings.
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EMPLOYEE DIRECT DEPOSIT ENROLLMENT FORM
PDF template
A form allowing employees to set up direct deposit of their paycheck with bank account details and authorization.
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Authorization Agreement For Direct Deposits
PDF template
A form allowing employees to set up direct deposit of their paycheck with bank account details and authorization.
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Employer Authorization Direct Deposit Form
PDF template
A form allowing employees to authorize direct deposit of their payroll into a bank account at Webster Bank.
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Direct Deposit Form
PDF template
A form for employees to set up, change, or cancel direct deposit of their paycheck into a financial institution account.
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Direct Deposit Authorization
PDF template
A form for employees to set up, modify, or cancel direct deposit banking information for payroll purposes.
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Direct Deposit Enrollment Form
PDF template
A form allowing employees to set up direct deposit of their paycheck into bank accounts with authorization and account details.
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Authorization Agreement For Direct Deposit
PDF template
A form for employees to authorize direct deposit of their paycheck into one or more bank accounts.
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Payroll Direct Deposit Authorization Form
PDF template
A form for employees to set up or modify direct deposit banking information for payroll at Coquille School District
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Electronic Direct Deposit Authorization Agreement For Pre Authorized CreditsDebits
PDF template
A form for employees to authorize electronic direct deposit of payroll funds into their bank account(s)
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Direct Deposit Authorization Form
PDF template
A form for employees to authorize electronic paycheck direct deposit into one or more bank accounts.
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Payroll Direct Deposit Authorization Form
PDF template
Form for University System of New Hampshire employees to authorize electronic direct deposit of fixed amounts from their paycheck.
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Direct Deposit Form For Related Entity Employees
PDF template
A form for employees to provide bank account details for receiving salary payments via direct deposit.
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Employee Direct Deposit Authorization Instructions
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Form for employees to set up automatic paycheck deposits into one or two bank accounts with verification requirements.
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Form 61 (Rev July 2021) UNITED ASSOCIATION NATIONAL PENSION FUND DIRECT DEPOSIT AUTHORIZATION FORM
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Form for authorizing direct deposit of pension fund benefits and providing bank account details for benefit payments.
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Direct Deposit Authorization Agreement
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Direct Deposit Form
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Form for employees to provide bank account details for direct deposit of payroll earnings.
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University System Of New Hampshire Payroll Direct Deposit Authorization Form
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A form for employees to authorize electronic direct deposit of payroll and reimbursement payments by the University System of New Hampshire.
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Direct Deposit Application
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Direct Deposit Authorization Form
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A form for employees to authorize direct deposit of wages to a bank account, with options to start, stop, or change existing direct deposit arrangements.
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Direct Deposit Form
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Form for employees to provide bank account details for payroll direct deposit, allowing setup of primary and optional secondary accounts.
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Payroll Direct Deposit Request Form (For Retirees Beneficiaries)
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Form for retirees and beneficiaries to set up or change direct deposit for pension payments with Employees' and Elected Officials' Retirement Systems.
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Direct Deposit Authorization Form
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Form for authorizing direct deposit of retirement benefits for Alameda County Employees' Retirement Association members.
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Self Service Direct Deposit
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Instructions for employees to set up or modify direct deposit through the Employee Dashboard in Porches/HR system.
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Direct Deposit Worksheet
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Request For Direct Deposit Form
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Direct Deposit Form Direct Deposit Switch Kit Form
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ACHform 2022
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A form for pension plan members to set up or modify direct deposit banking information for retirement benefits.
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Direct Deposit Worksheet
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Form for employees to set up direct deposit bank information for payroll services with multiple account options.
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Direct Deposit Form For NYS Employees
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A form for New York State employees to set up or modify direct deposit banking information for salary payments.
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Directed Quarantine Leave Request Form
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Form for Philadelphia School District employees to request paid quarantine leave due to COVID-19 exposure or positive test result.
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Columbus County Direct Deposit Form
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Form for employees to authorize direct deposit of payroll funds into their bank accounts.
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DOTM FORM DAL Request Form
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A form for employees to request COVID-19-related leave under the Department of Military's Directors Authorized Leave policy.
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Direct RolloverTransfer To ICMA RC Form
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A form for transferring retirement plan assets between providers, specifically to an ICMA-RC account.
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DIS 101C V7 EMPLOYEE STATEMENT DISABILITY CLAIM FORM
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A comprehensive form for employees to file a disability claim for short-term or long-term disability benefits.
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Disability Allowance To Service Retirement Application
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A form for CalSTRS members transitioning from disability allowance to service retirement, providing instructions for benefit conversion.
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Disability Benefit Application Form
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Official government form for applying for disability benefits in Bermuda, detailing eligibility requirements for contributory and non-contributory disability benefits.
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PSOB Disability Benefits Program Checklist
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A comprehensive checklist for filing disability claims for public safety officers with the U.S. Department of Justice's PSOB Office.
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SUPPLEMENTAL DISABILITY CLAIM FORM
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Claim form for submitting a disability benefit request for IUOE Local 132 Health and Welfare Fund participants
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Group Disability Claim Filing Instructions
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Instructions for filing a disability insurance claim with American Fidelity Assurance Company, detailing the required steps and documentation.
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DISABILITY HEALTH WELFARE HOURS CLAIM FORM
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A form for participants to claim disability hours and benefits through the Southwest Carpenters Health & Welfare Trust
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Disability Health Welfare Hours Claim Form
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A form for carpenters to claim disability health and welfare hours due to illness or injury, requiring participant and physician statements.
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Disability Coverage Claim Form
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Insurance claim form for filing a disability coverage claim with American Heritage Life Insurance Company.
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Disability Claim Form
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A comprehensive form for submitting a disability insurance claim, detailing the policyholder's medical condition and disability status.
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Delta Pilots Mutual Aid Disability Claim Form
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Disability claim form for Delta pilots to request benefits and authorize medical information release and payment processing.
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Short Term Disability Claim Form
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A comprehensive form for employees to file a claim for short-term disability benefits, requiring input from the employee, employer, and attending physician.
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Disability Claim Form Instructions
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Comprehensive instructions for filing a disability insurance claim with sections for physician, claimant, and employer statements.
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Disability Claim Form
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A comprehensive disability claim form for union members to document medical conditions, work status, and employer information.
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New York State NOTICE AND PROOF OF CLAIM FOR DISABILITY BENEFITS
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Official New York State form for filing a disability benefits claim, to be used by employees who became disabled while employed or within four weeks of employment termination.
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MetLife Disability Insurance Guide
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A comprehensive guide for reporting disability claims and absence procedures through MetLife insurance.
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Disability Claim Form
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A comprehensive form for filing a disability claim with the Teamsters Joint Council No. 83 of Virginia Health & Welfare and Pension Funds.
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Disability Application Glossary Of Terms
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A comprehensive guide defining key terms and requirements for disability retirement applications for public employees in Massachusetts.
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Supplementary Disability Claim Form
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A form used to submit disability claims, requiring details from both the claimant and attending physician about an employee's inability to work.
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Disability Support Pension Application Form
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A comprehensive form for individuals seeking financial support due to disability, covering eligibility, evidence requirements, and application process.
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SI 11268 Your Disability Benefit Claim
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Application packet for submitting a long-term disability benefits claim, including instructions for completing required forms.
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Adapted Physical Education Program Medical Form
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Medical form documenting student's disability, exercise limitations, and physical capabilities for adapted physical education program participation.
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How To File A Claim For Weekly Disability Benefits
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Comprehensive guide for filing a disability benefits claim, including required documentation and medical certification requirements.
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Documenting Discipline Issues
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A comprehensive checklist for managers to properly document employee disciplinary actions and performance issues.
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NON UNIFORM EMPLOYEE DISCIPLINARY ACTION FORM
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A formal document recording an employee's demotion and the reasons for disciplinary action.
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Waccamaw EOC, Inc. Disciplinary Action Form
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A formal document used to record and document workplace misconduct and associated disciplinary measures for an employee.
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Disciplinary Action Form
PDF template
Official form for documenting employee disciplinary actions, including details of the disciplinary process and required signatures.
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Disciplinary Action Form
PDF template
A formal document used to document workplace misconduct, disciplinary actions, and performance issues for an employee.
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Disciplinary Action Form
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A form documenting performance issues and potential disciplinary actions for non-civil service employees.
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Payroll Deduction Authorization Form
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A form allowing FIU employees to authorize payroll deductions for summer camp registration expenses.
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DISCRETIONARY EXPENSE APPROVAL FORM
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A form for employees to request approval of discretionary expenses with detailed category breakdown and multiple levels of authorization.
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International Medical History Form
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Comprehensive medical form for collecting personal health information, emergency contacts, and medical history for international travel purposes.
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International Medical History Form
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Comprehensive medical history and emergency contact form for international travelers to ensure safety and medical preparedness.
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QP Distribution Notice
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A comprehensive notice explaining distribution options and tax consequences for retirement plan participants.
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DIVING MEDICAL HISTORY FORM
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A comprehensive medical history form designed to assess an individual's fitness and health risks for participating in scuba diving activities.
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Retirement Scheme Divorce Benefit Information Form
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A form collecting member details for potential benefit distribution in the event of a divorce order affecting a retirement fund
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Retirement Scheme Divorce Benefit Information Form
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A form for collecting member information related to potential benefit distribution in the context of a divorce order
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DIY Docs
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An online legal document creation and storage tool provided by ARAG for employees to generate and manage legal documents independently.
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Employee Resignation Form
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Official form for employees to submit their resignation from College of the Mainland, documenting reasons and effective date of departure.
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Employee Resignation Form
PDF template
Official form for employees to submit their resignation from College of the Mainland, documenting reasons and effective date of departure.
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DoctorS Signature Form
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A comprehensive medical form for documenting a camper's health information, medical history, medications, and physician details.
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Direct Deposit Form
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Form for employees to set up, change, or cancel direct deposit banking information for payroll at California State University Long Beach Research Foundation.
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Direct Deposit Form
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Form for employees to establish, modify, or cancel direct deposit banking instructions for payroll payments.
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Authorization For Use Or Disclosure Of Protected Health Information (PHI)
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A legal form allowing authorized use and disclosure of an individual's protected health information by the Hawaii State Department of Health.
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COVID 19 Emergency Paid Leave (EPL) Employee Notification And Supplemental Leave Request Form
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Form for federal employees to request emergency paid leave related to COVID-19 circumstances and qualifying conditions
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Good Fit Domestic Partner Affidavit
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A form for active and retired employees to add or terminate domestic partner and dependent coverage for various insurance plans.
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DONATION APPROVAL FORM
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A form for documenting and obtaining approval for donations to the Board of Education.
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City Of Antioch Police Department Donor Contribution Form
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A form for individuals to make financial contributions to various police department programs and initiatives
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Donation Form
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A form for documenting monetary or property donations to Granite School District with details about the donation and donor.
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Private Contribution Form
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Contribution Form (Print And Return)
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A donation form for supporting the Department of Geography and Geology at Western Kentucky University through financial contributions.
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DonationContribution Form
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A form used to document and evaluate potential organizational donations or contributions to an event or function.
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Oaks Of Louisiana Contribution Form
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A form for making financial contributions to The Oaks of Louisiana, allowing donors to specify donation amount and designation.
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Contribution Form
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A comprehensive form for making financial contributions to Capital University, allowing donors to specify gift amounts, designations, and payment methods.
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Youngstown State University Gift In Kind Donor Submission Form
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A form for documenting and submitting non-monetary donations to Youngstown State University
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Donor Leave Request Form
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A form for employees to request leave for organ, blood, or other donation activities under the Kansas State Donor Program.
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Spot Award Nomination Form
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A form for nominating USC Dornsife employees for a performance recognition award with detailed nomination and eligibility criteria.
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Disciplinary Action Form
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A form used to document and submit disciplinary actions for employees within a civil service jurisdiction.
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Disability Benefit Application Instructions
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Comprehensive instructions for submitting a disability benefit application, including eligibility requirements and submission guidelines.
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Driver Medical History Form
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Medical history and physical examination form for taxi and limousine drivers to assess fitness for operating a motor vehicle.
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Contribution Form
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A form for making check contributions to the DreamAhead College Investment Plan 529 savings account with specific contribution guidelines.
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Payroll Deduction Guide
PDF template
Comprehensive guide for employees and employers on setting up payroll deductions for the DreamAhead College Investment Plan.
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Integrative Medicine Intake Form
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Comprehensive medical intake form for patients seeking integrative medicine services, collecting medical history, current health concerns, and personal health information.
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DROP Enrollment Form New Participant
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A form for qualifying members to enroll in the Municipal Fire and Police Retirement System of Iowa's Deferred Retirement Option Plan.
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DROP Enrollment Form New Participant Enrollment
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Enrollment form for municipal firefighters and police officers to participate in the Deferred Retirement Option Plan (DROP) program.
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Drug Free Workplace Act Of 1988
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Policy prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances for college employees and students.
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Drug Testing Consent Form
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A comprehensive consent form for drug testing administered by the Manila Health Department Public Health Laboratory for various purposes.
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BP 5131.61 Student Athlete Drug Testing
PDF template
A school district policy establishing a drug testing program for student athletes to promote health, safety, and deterrence of substance abuse.
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DSB 0311 Employee Administration Request Form
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Form for managing employee administrative actions for the NC Department of Health and Human Services Division of Services for the Blind.
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Medical Examination Form
PDF template
Comprehensive medical examination form documenting patient's physical condition, vision, hearing, and overall health status.
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Medical Examination For Immigrant Or Refugee Applicant (DS 2053)
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Comprehensive guide for panel physicians completing medical examinations for immigrant and refugee applicants, detailing required assessments and evaluation process.
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Student Insurance Claim Form
PDF template
A comprehensive insurance claim form for students to report medical examinations, illnesses, prescriptions, or injuries for insurance coverage.
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Direct Deposit Enrollment Authorization Form
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Authorization form for electronic benefit payments through direct deposit for Social Services programs in North Carolina.
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CONTRIBUTION FORM
PDF template
A detailed form inquiring about financial contributions and monetary support to specific individuals in a legal case.
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Contribution Form
PDF template
A bilingual form to determine financial contributions made by an individual to specific named persons.
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Informed Consent For Fitness Assessment
PDF template
Consent document for participating in a comprehensive fitness assessment conducted by exercise physiology students at the College of St. Scholastica during the City of Duluth Health Fair.
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Informed Consent For Fitness Assessment
PDF template
Consent document for a fitness assessment conducted by exercise physiology students at the College of St. Scholastica during a City of Duluth Health Fair.
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Richmond Retirement System Durable Power Of Attorney Fact Sheet
PDF template
A legal document explaining how Richmond Retirement System members can designate an agent to manage their retirement benefits under specific conditions.
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UM Employee Gift Payroll Deduction Form
PDF template
A form allowing University of Michigan employees to authorize charitable donations through payroll deduction.
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Employee Benefit Enrollment Form
PDF template
A comprehensive form for employees to select and enroll in medical, dental, and vision benefit plans.
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Name AndOr Address Change Form
PDF template
Form for employees to request name or address changes within the Central Consolidated School District's HR department.
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Employee Academic Tuition Waiver Request Form
PDF template
A form for Cameron University employees to request tuition waivers for themselves or their dependents for academic courses.
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View And Update Your Federal Tax Withholding (Form W 4) In Employee Access
PDF template
Instructions for viewing and updating federal tax withholding information online using ADP Employee Access platform.
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EAF Contribution Form
PDF template
A form for Camelback employees to voluntarily contribute to the Employee Assistance Fund through payroll deductions.
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EagleOne Payroll Deduction Form
PDF template
Form for employees to request payroll deductions for their EagleOne account with specified amount options.
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Hazard Report Form
PDF template
A standardized form for employees to report potential workplace safety hazards and risks.
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DENTAL APPLICATION AND POLICY CHANGE
PDF template
A comprehensive form for enrolling in or modifying dental insurance coverage, including options for new employees, open enrollment, COBRA, and membership changes.
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Example Travel Health Declaration Form
PDF template
A form for collecting traveler health information, specifically related to Ebola outbreak monitoring during international travel.
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Delaware Technical Community College Emergency Contact Form
PDF template
A confidential form for employees to provide emergency contact information for use by authorized personnel in case of an emergency.
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Claims Submission Form
PDF template
A form authorizing healthcare providers to submit and exchange personal information for insurance claims processing and benefits administration.
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DIRECT DEPOSIT FORM
PDF template
Form for employees to specify bank account details for paycheck direct deposit distribution across up to three accounts.
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NCAAR Drug Testing Program, 1999 2000
PDF template
Comprehensive drug testing program for student-athletes to ensure fair competition and athlete health and safety.
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Employee Declaration Form (EDF) Pay As You Earn (PAYE)
PDF template
Tax declaration form for employees in Mauritius to claim various tax reliefs, deductions, and allowances for the income year 2024-2025.
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Foundation Contribution Payroll Deduction Form
PDF template
A form allowing GRCC employees to authorize payroll deductions for foundation scholarships and contributions.
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Educational Seminar Grant Evaluation Form
PDF template
A form for documenting and evaluating educational seminars funded by the Collie Health Foundation, including event details, costs, and educational impact.
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Direct Deposit Authorization Form
PDF template
Form for employees to authorize electronic deposit of benefit reimbursements to a bank account
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New York Council Of Nonprofits, Inc. Enrollment Form
PDF template
Enrollment form for Health Care and Dependent Care Flexible Spending Accounts with options for salary reduction and reimbursement methods
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ENROLLMENT INSTRUCTIONS OPEN YOUR RETIREMENT ACCOUNT
PDF template
Instructions for opening a retirement account, choosing investments, and completing enrollment with TIAA.
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HSA Enrollment Form
PDF template
A form for enrolling in a Health Savings Account through an employer, allowing employees to set up contributions.
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Traveler Health And Medical Information
PDF template
A comprehensive guide for group leaders to collect and manage travelers' medical information and health considerations during travel programs.
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American Rescue Plan Act (ARPA) Emergency Family Medical Leave Request Form
PDF template
A form for employees to request extended family medical leave related to COVID-19 under the American Rescue Plan Act.
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Emergency Family Medical Leave Request Form
PDF template
Detailed guidance for employees on completing timesheets and tracking Emergency Family and Medical Leave (EFML) usage and compensation.
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Power Of Attorney (POA)
PDF template
A form allowing participants or beneficiaries to designate an agent to act on their behalf with the Pension Benefit Guaranty Corporation (PBGC).
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Employee Actions EForm
PDF template
Comprehensive electronic form for managing various employee-related actions including hiring, transfers, pay changes, and terminations.
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EnhanceFitness Post Program Evaluation Form
PDF template
A survey assessing participant experience and physical activity levels in the EnhanceFitness program.
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EFT AUTHORIZATION FORM
PDF template
Authorization form for setting up recurring electronic donations to the University of Illinois Foundation through checking or savings account.
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Tabor College Contribution Form
PDF template
A form for making financial contributions to Tabor College through multiple gift options including cash, credit card, and electronic funds transfer.
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Deferred Compensation PlanNYCE IRA Direct Deposit Form
PDF template
Form for setting up direct deposit for various retirement account types, including 457, 401(k), and NYCE IRA accounts.
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Gift In Kind Guidelines And Contribution Form
PDF template
Form for documenting in-kind gifts to an organization, with sponsorship levels and contribution details.
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Extended Health Care Claim Form
PDF template
A comprehensive form for submitting medical and health care expense claims to an insurance provider, requiring detailed personal and coverage information.
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Emergency Eye Wash Monthly Inspection Form
PDF template
Guidelines for monthly inspection and maintenance of emergency eye wash stations in laboratory settings to ensure safety and proper functionality.
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LABORATORY SAFETY INSPECTION WORK FORM
PDF template
A comprehensive checklist for evaluating safety protocols and environmental conditions in laboratory settings
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STUDENT MEDICAL HISTORY
PDF template
Comprehensive medical history form for students, covering various health aspects and potential medical conditions.
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Service Request Form
PDF template
A form for requesting environmental, health, and safety services from Environmental, Health & Safety Solutions, Inc.
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USEF Competition EHV 1 Declaration Form
PDF template
A health declaration form for horse owners and trainers to certify their horses' health status and exposure risk for EHV-1 at competitive events.
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EZ Retirement Plan Enrollment Form
PDF template
Enrollment form for Florida Retirement System employees to choose between Investment and Pension Plan options.
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General Retirement Plan Enrollment Form
PDF template
Enrollment form for new employees to choose between retirement plan options in the Florida Retirement System for Regular, Special Risk, and Special Risk Administrative Support Class Employees.
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Request For Quotes Election Services For PERS Board Positions
PDF template
Solicitation for blended election services for PERS Board positions representing Institutions of Higher Learning Employees and Retirees.
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Request For Proposal Materials And Services For Elections Of Employees Retirement Systems And Teache
PDF template
A request for proposal to select a vendor to provide materials and services for administering retirement system board elections during a five-year period.
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Consent Form For Electronic Distribution Of Benefit Materials And Notices
PDF template
A consent form allowing employees to receive electronic copies of benefit materials and notices from Michigan State University.
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Electronic Payment Authorization Agreement Form
PDF template
A form for employers to set up electronic payment methods for various California State Teachers' Retirement System contributions and payments.
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Electronic Payment Authorization Agreement Form
PDF template
Form for setting up electronic payment methods for California State Teachers' Retirement System contributions and payments
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RapidPayDirect Deposit Authorization Enrollment Form
PDF template
Form for Elmhurst University employees to set up direct deposit or RapidPay! Visa PayCard for receiving wages.
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Emergency Medicine Action Fund Contribution Form
PDF template
A donation form for contributing to the Emergency Medicine Action Fund with multiple funding levels and contribution options.
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Active Directory And Email Access Request Form
PDF template
Form for requesting and authorizing Active Directory and email system access for faculty, staff, and consultants
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Emergency Contact Form
PDF template
Form for collecting emergency contact details and medical information for children participating in a program.
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Emergency Contact Form
PDF template
A form for collecting personal health details and emergency contact information for club or organizational trips.
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Emergency Contact Form
PDF template
A form for employees to list up to four emergency contacts to be used in case of emergencies during work hours or in town buildings.
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St. Joseph School Emergency Contact Information
PDF template
Form for collecting student emergency contact details, health information, and parental consent for medical care
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Emergency Contact Form 32018
PDF template
A form for employees to provide contact information for emergency purposes and primary/secondary emergency contacts.
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Emergency Contact Form
PDF template
A comprehensive form for collecting student emergency contact details, medical information, and guardian contact information for school records.
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Employee Emergency Contact Information
PDF template
A form for employees to provide emergency contact details for use in case of urgent situations.
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Student Emergency And Release Form
PDF template
Confidential form for collecting student medical information, emergency contacts, and special needs details for Howell Mountain Elementary School District.
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EMERGENCY CONTACT FORM
PDF template
A comprehensive form for collecting emergency contact and health information for a child enrolled in preschool
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Emergency Contact Information Form
PDF template
A document for collecting employee emergency contact details and medical information for use in urgent situations.
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Health Office Emergency Contact Form
PDF template
A comprehensive form collecting student contact, medical, and insurance information for school emergency purposes.
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Law Clerk Employee Data And Emergency Contact Form
PDF template
A form for collecting employee personal information and emergency contact details for law clerks in Maryland court system.
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Emergency Contact Form
PDF template
A form for employees to provide emergency contact details for workplace safety and communication purposes.
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Hickory Hill Member Family Emergency Contact Form
PDF template
A form for collecting emergency contact information and medical authorization for family members at a club or organization.
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Emergency Contact Information
PDF template
A form for collecting employee emergency contact details and notification preferences for campus safety purposes.
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Emergency Coronavirus Paid Leave Request Form
PDF template
Form for City of Birmingham employees to request paid leave related to COVID-19 emergency situations
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Emergency Coronavirus Paid Leave Request Form
PDF template
Form for City of Birmingham employees to request emergency paid leave related to COVID-19 pandemic circumstances.
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Mennonite Village Covid 19 Earned Leave Request Form
PDF template
A form for employees to request leave due to positive COVID-19 test or related symptoms
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Emergency Paid Sick Leave Request Form For COVID 19 Related Leave
PDF template
A form for employees to request emergency paid sick leave related to COVID-19 under the Families First Coronavirus Response Act.
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Emergency Medical Release Form
PDF template
A comprehensive medical form for collecting health information and emergency contact details for participants in adaptive or therapeutic horseback riding programs.
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Emergency Paid Sick Leave Act Leave Request Form
PDF template
Employee form for requesting paid sick leave related to COVID-19 under the Emergency Paid Sick Leave Act.
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Emergency Paid Sick Leave Request Form
PDF template
A form for employees to request paid sick leave related to COVID-19 under the Emergency Paid Sick Leave Act.
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Emergency Paid Sick Leave Request
PDF template
Form for employees to request emergency paid sick leave under the Families First Coronavirus Response Act during the COVID-19 pandemic.
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Emergency Paid Sick Leave Request Form
PDF template
Form for employees to request emergency paid sick leave related to COVID-19 circumstances
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Reimbursement Claim Form
PDF template
Instructions for submitting healthcare reimbursement claims through multiple methods including Rx debit card, online portal, and paper submission.
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Emeriti Retirement Health Solutions Personal Contribution Form
PDF template
A form for making personal contributions to an employer-sponsored retirement health plan managed by TIAA-CREF.
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Emeriti Reimbursement Benefit Claim Form
PDF template
Instructions for submitting healthcare reimbursement claims through Rx debit card, online portal, or paper submission.
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Emeritus Nomination Form
PDF template
A formal process for nominating retiring faculty, staff, and administrators for emeritus recognition at Salt Lake Community College.
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EMERGENCY MEDICAL FORM
PDF template
A form for parents to authorize emergency medical treatment for students and provide critical medical contact and health information.
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Emory Card Eagle Dollars Employee Payroll Deduction Form
PDF template
Form for Emory University employees to authorize payroll deductions for Eagle Dollars account
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Employee Equipment Loan Agreement
PDF template
A legal document for employees borrowing equipment from James Madison University, outlining responsibilities and conditions of equipment loan.
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Contribution Form
PDF template
A form for individuals and organizations to make financial contributions to the Emergency Medicine Policy Institute during their 2020 campaign.
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HR 122 Employee Incident Report
PDF template
A detailed form for documenting workplace incidents and injuries for employees of Biggs Unified School District.
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EMPLOYEE ACKNOWLEDGEMENT FORM
PDF template
Form documenting employee understanding of background check requirements under California Assembly Bill 506 of 2021.
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Employee Acknowledgement Form
PDF template
A form acknowledging an employee's understanding of background check requirements under California Assembly Bill 506 of 2021.
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LIFT WHERE YOU STAND EMPLOYEE GIVING CAMPAIGN 2018 EMPLOYEE PAYROLL DEDUCTION FORM
PDF template
A form for employees to authorize charitable donations through payroll deductions for the annual giving campaign.
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Employee Bridge Of Service Review Form
PDF template
A form used to review an employee's service continuity and eligibility for service credit during multiple employment periods.
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Employee Change Of Address Form
PDF template
A form for employees to update their address and telephone number with the school district.
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BHSSC Employee Change Of Address Form
PDF template
A form for employees to update their personal contact information and address details with their employer.
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Complaint Form
PDF template
A form for employees to formally file workplace complaints or request informal resolution of workplace issues.
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Employee Complaint Resolution Procedure
PDF template
A formal procedure for resolving work-related employee concerns and complaints within the Technical College System of Georgia, ensuring fair treatment and communication.
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Employee Complaint Resolution Form
PDF template
A form for employees to document and submit workplace complaints, detailing issues and requested resolutions.
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EMPLOYEE COMPLAINT FORM
PDF template
A comprehensive form for employees to document workplace concerns including discrimination, harassment, ethical, or safety issues.
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VR FEE FOR SERVICE PROVIDER EMPLOYEE CONTACT FORM
PDF template
A form for documenting employee details and services for vocational rehabilitation providers
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EMPLOYEE CONTRIBUTION FORM
PDF template
A form allowing employees to establish, modify, or continue payroll deductions for foundation donations.
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Lamar Community College Foundation Employee Contribution Form
PDF template
A form allowing Lamar Community College employees to make monthly payroll donations to support student programs and college initiatives.
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Employee Course Registration Form
PDF template
Form for Gustavus employees to register for courses with tuition benefits, requiring HR and supervisor approvals.
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Employee Data Request Form
PDF template
A form for collecting comprehensive employee information to support the electronic appointment process in an organization's human resources workflow.
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NHRDeparture Employee Departure Information Sheet
PDF template
A comprehensive guide for faculty and staff leaving their position at the University of Wisconsin Madison, covering benefits, computer access, leave balances, and other departure-related information.
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Direct Deposit EnrollmentCancellation Form
PDF template
A form for employees to set up, change, or cancel direct deposit of payroll funds into bank accounts.
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EMPLOYEE DISCIPLINARY ACTION FORM
PDF template
A formal document used to record and document employee workplace violations, warnings, and disciplinary actions.
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EMPLOYEE DISCIPLINARY ACTION FORM
PDF template
A formal document used to record and document employee misconduct, performance issues, or policy violations in the workplace.
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Employee Disciplinary Action Form
PDF template
Formal document used to record and document workplace disciplinary actions and violations by employees.
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EXTERN EMERGENCY CONTACT FORM
PDF template
Form for collecting emergency contact details for external personnel or employees at a veterinary organization.
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EMPLOYEE EMERGENCY CONTACT FORM
PDF template
A form for employees to provide personal and emergency contact details for use in urgent situations.
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EMPLOYEE EMERGENCY CONTACT FORM
PDF template
A form for employees to provide emergency contact information for use in case of urgent situations.
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EMPLOYEE EMERGENCY CONTACT FORM
PDF template
A comprehensive form for collecting employee personal and emergency contact details for human resources purposes.
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Employee Emergency Medical Form
PDF template
Confidential form for collecting employee emergency contact details, medical conditions, and treatment consent.
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ENROLLMENT, CHANGE, CANCELLATION, OR OPT OUT EMPLOYEES ONLY HEALTH AND WELFARE PLANS
PDF template
A form for Lawrence Livermore National Security employees to enroll, change, cancel, or opt out of health and welfare benefit plans.
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ENROLLMENT FORM FOR GROUP INSURANCE
PDF template
A comprehensive form for enrolling in group insurance benefits, capturing employee and dependent information, coverage selections, and authorization.
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Employee Evaluation Form
PDF template
A comprehensive employee performance assessment document with rating scales and sections for job knowledge, work quality, and goal setting.
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Employee Evaluation Form
PDF template
A comprehensive form for evaluating employee performance across multiple professional competencies and setting future goals.
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Employee Evaluation Form
PDF template
A comprehensive form for evaluating employee performance across multiple skill and competency areas.
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STATE OF KANSAS BIDDERS PREFERENCE PROGRAM EMPLOYEE EVALUATION FORM
PDF template
A form for documenting employee background, disabilities, and employment barriers for potential preference program eligibility.
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Employee Exit Checklist
PDF template
Comprehensive form documenting employee departure procedures, including credential return, benefits termination, and administrative tasks.
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Employee Exit Checklist Form
PDF template
A comprehensive form for managing employee separation process, ensuring return of district property and proper administrative procedures.
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Employee SeparationTransfer Checklist
PDF template
A comprehensive checklist for supervisors to manage employee departures or transfers, including access revocation and administrative procedures.
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Employee Travel Expense Report Form
PDF template
Form for documenting and requesting reimbursement of employee travel-related expenses by Claremore Public Schools.
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EMPLOYEE FEEDBACK FORM
PDF template
A comprehensive form for evaluating employee performance, identifying strengths, development needs, and creating an action plan for professional growth.
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Educational Foundation Contribution Form
PDF template
Form for employees to make tax-deductible contributions to the Delaware Technical Community College Educational Foundation through payroll deduction, cash, or pledge.
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Employee HSA Payroll Deduction Form
PDF template
Form for employees to authorize payroll deductions for Health Savings Account contributions with annual contribution limits and details.
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Employee HSA Payroll Deduction Form
PDF template
Form for employees to authorize payroll deductions for Health Savings Account contributions with annual contribution limits and employer details.
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Employee HSA Payroll Deduction Form
PDF template
Form for employees to authorize payroll deductions for their Health Savings Account contributions with contribution limit details.
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Employee Information Change Form
PDF template
A form for employees to update their personal contact information with their employer's human resources department.
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Employee Information Form
PDF template
A comprehensive form for collecting personal, contact, demographic, veteran status, and educational background information for new employees.
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Employee Injury Report Form
PDF template
A form for documenting employee workplace injuries, incidents, and medical treatment details for workplace safety and insurance purposes.
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Employee Inquiry Form
PDF template
A form used by employees to submit inquiries to the Human Resource Services department at Newark Public Schools.
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Employee Internal Complaint Intake Form
PDF template
A form for reporting policy violations and discrimination complaints at St. Mary's College of Maryland.
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Record Of Employee Interview
PDF template
Confidential document for interviewing construction workers to verify employment details and compliance with labor standards.
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Employee Inventions Act
PDF template
Legal document governing employee inventions, service inventions, and technical improvement proposals in employment contexts.
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Warner Pacific University Employee Leave Request Form
PDF template
A comprehensive form for employees to request various types of leave, including FMLA and OFLA leave options
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Employee Parking Policy
PDF template
Policy establishing parking provisions and regulations for county employees using county parking facilities and lots.
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Employee Of The Month Nomination Form
PDF template
A form for nominating employees in specific job categories for a monthly recognition award within an educational institution.
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Facilities And Campus Services Employees Of The Quarter Nomination Form
PDF template
A form for nominating exceptional employees or teams in the Facilities and Campus Services department who demonstrate outstanding performance and organizational values.
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Virginia Tech Employee Software Sales Order Form
PDF template
Order form for Virginia Tech employees to purchase software and technology accessories at discounted rates.
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Employee Paid And Unpaid Time Off Request Form
PDF template
A form for employees to request paid or unpaid time off, requiring approval from their supervisor.
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Employee Paid And Unpaid Time Off Request Form
PDF template
A form for employees to request paid or unpaid time off, requiring supervisor approval and documentation.
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EMPLOYEE PAYMENT AGREEMENT FORM
PDF template
A form for documenting an employee's payment schedule and financial obligations to an organization.
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Employee Payroll Deduction Form For Full Time Employees And Staff
PDF template
Form allowing employees to set up monthly charitable contributions through payroll deduction to Missouri State University Foundation
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Current Lincoln University Employee Payroll Deduction Form
PDF template
Form for Lincoln University employees to set up recurring payroll donations to the Lincoln University Foundation of PA
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UAB GIFT RECORDS EMPLOYEE PAYROLL DEDUCTION FORM
PDF template
A form for UAB employees to authorize automatic payroll deductions for charitable contributions to specific funds or programs.
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Employee Contribution And Payroll Deduction Form
PDF template
A form for employees to specify contribution amounts, payment methods, and recognition preferences for donations.
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Employee Contribution Form
PDF template
A form allowing employees to make charitable contributions through automatic payroll deductions to support Great Basin College scholarships and programs.
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Employee Payroll Deduction Form
PDF template
A payroll deduction authorization form for employees to contribute to the Germanna Community College Educational Foundation
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Staff Appraisal
PDF template
A comprehensive employee performance review document for documenting and evaluating staff performance, goals, and development
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Employee Performance Evaluation Form
PDF template
A comprehensive performance evaluation form for assessing employee job performance, development, and potential promotion opportunities.
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Request For Prescription Delivery
PDF template
A form for employees to request prescription delivery with patient and delivery details.
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Employee Profile And Travel Form
PDF template
A comprehensive form for employees to update personal information, marital status, and travel privileges for family members.
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Employee Progress Performance Review
PDF template
A comprehensive employee performance review document for rating job performance, skills, and goal achievement.
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Employee Purchase Form
PDF template
A form allowing employees to purchase items and choose payment methods, including payroll deduction and credit card options.
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Employee Referral Form
PDF template
Form for employees to refer potential job candidates to Albert Einstein College of Medicine with guidelines for referral awards.
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Employee Referral Form
PDF template
A form for employees to refer potential candidates and participate in the company's referral bonus program.
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Employee Referral Program Referral Form
PDF template
A form for employees to refer potential job candidates to open positions within the organization.
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Employee Resignation Form
PDF template
Official form for employees to submit their resignation from Jackson County Public Schools, detailing reasons for leaving and effective date.
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Employee Resource Document
PDF template
A comprehensive guide for University of Scranton employees detailing emergency contacts, campus resources, and essential operational information.
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Employee Retirement Contribution Form
PDF template
Form for employees to start, change, or suspend retirement plan contributions at Mountainland Technical College.
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Employee Performance Review Form
PDF template
A comprehensive form for assessing employee performance across multiple competency and behavioral dimensions with rating scales.
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M NCPPC Benefits EnrollmentChange Form
PDF template
Form for employees to enroll in or modify benefits, including medical, dental, and prescription plans.
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Employee Self Assessment Form
PDF template
A comprehensive self-evaluation form for employees to reflect on their job performance, achievements, and goals.
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Employee Self Service Guide
PDF template
Comprehensive guide for navigating the Employee Self Service (ESS) portal and accessing various employee-related resources and information.
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Form 43 Employee TransferSeparation Clearance Form
PDF template
A form used to document and track the clearance process for employees transferring departments or separating from the university.
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HR64 Employee Separation Checklist
PDF template
A comprehensive form documenting the process and requirements for an employee's exit from the organization, including equipment return and account deactivation.
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Employee Services FAQ Contact List
PDF template
A comprehensive contact reference for employees covering various HR topics, benefits, and service inquiries.
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Employee Status Requisition
PDF template
A document used to initiate and document changes in employee status within an organization's human resources processes.
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Employee Time Off Request
PDF template
A form for employees to request time off for various reasons, requiring supervisor approval.
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Employee Time Off Request Form
PDF template
A form for personal care assistants (PCAs) to request paid or unpaid time off, with requirements for submission and approval.
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Employee Time Off Request Form
PDF template
A form for employees to request time off, specifying type and duration of leave and requiring manager approval.
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Employee (StudentStaff) Timesheet
PDF template
A comprehensive timesheet form for tracking employee work hours across multiple weeks and shifts with absence code tracking.
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Employee And Dependent Tuition WaiverReimbursement Form
PDF template
Form for employees to request tuition waiver or reimbursement for themselves or dependents at SSU.
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Eye Care Insurance Enrollment Form
PDF template
A comprehensive form for employees to enroll in or modify eye care insurance coverage for themselves and dependents.
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Health Coverage Waiver Form
PDF template
A document allowing employees to waive health insurance coverage offered by their employer with options for alternative coverage.
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Disciplinary Action Form
PDF template
A formal document used to record and document employee misconduct, policy violations, and disciplinary actions.
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Employee Write Up Forms Packet
PDF template
Comprehensive packet of forms for documenting employee workplace issues, complaints, and disciplinary actions.
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New Patient Intake Form
PDF template
Comprehensive medical form for collecting new patient health history, chronic conditions, surgical history, medications, and family medical background.
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Employer Error Institution Process
PDF template
Guidelines for handling employer errors in employee insurance enrollment, detailing steps for institutions and employees to correct coverage issues.
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NEW PATIENT INTAKE FORM
PDF template
A comprehensive medical history form for new patients, capturing personal information, medical history, and current health concerns.
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Windfall Elimination Provision
PDF template
Explanation of how Social Security retirement or disability benefits may be reduced for workers with pensions from employers not withholding Social Security taxes.
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How To File A Disability Appeal Online
PDF template
Step-by-step instructions for filing a disability appeal online with the Social Security Administration
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Adult Disability Starter Kit
PDF template
A comprehensive checklist to help applicants prepare for filing a Social Security disability benefits claim by organizing personal, medical, and employment information.
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Authorization And Consent To Treatment
PDF template
A comprehensive document outlining patient consent for medical treatment, insurance benefits assignment, and payment responsibilities.
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Contribution Form
PDF template
A form for employees to make voluntary donations to the Enhabit Cares Foundation through payroll deduction, check, or credit card.
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Enhanced Dental Benefits Enrollment Form
PDF template
A self-enrollment form for additional dental coverage for members with specific medical conditions through Blue Cross Blue Shield of Massachusetts.
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Enroll A Member NYSLRS Quick Guide
PDF template
A step-by-step guide for personnel contacts to enroll new members in the New York State and Local Retirement System online platform.
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State Of Hawaii PTS Deferred Compensation Retirement Plan Enrollment Form
PDF template
Enrollment form for part-time, temporary, and seasonal employees of the State of Hawaii and County of Kauai for deferred compensation retirement plan
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Northern California Carpenter Funds Enrollment Form
PDF template
Form for enrolling or updating records with the Northern California Carpenter Funds, including health plan selection and participant information.
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Vision Service Plan EnrollmentChange Form
PDF template
Form for employees of Fallbrook Elementary School District to enroll or modify vision insurance coverage for themselves and dependents.
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Superior Dental Care Employee Enrollment Form
PDF template
Form for employees to enroll in dental and vision insurance benefits through Superior Dental Care.
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ENROLLMENT FORM GL.2017.010
PDF template
A comprehensive employee insurance enrollment form for selecting life and AD&D coverage options for employees and dependents.
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NEA Membership Enrollment Form CCA
PDF template
Enrollment form for teachers to join the National Education Association, California Teachers Association, and local education unions.
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Westtown Township Health And Wellness Registration And Insurance Form
PDF template
Registration form for Westtown Township's fitness programs including Pilates and Yoga, with health history and consent sections.
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California State University, Sacramento Benefit Enrollment Worksheet
PDF template
A form for employees to complete transactions affecting health, dental, vision, and FlexCash coverage at California State University, Sacramento.
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City Of Albany 457 Deferred Compensation Plan Enrollment And Contribution Form
PDF template
A form for City of Albany employees to enroll in or modify contributions to their 457 Deferred Compensation Plan at MissionSquare Retirement.
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ENROLLMENT FORM NATIONAL ELEVATOR INDUSTRY BENEFIT PLANS
PDF template
An enrollment form for employees of the National Elevator Industry to enroll in benefit plans and update personal and dependent information.
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Health History Examination Form South Carolina Envirothon Program
PDF template
Comprehensive health and emergency contact form for documenting medical information and insurance details for program participants.
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Vermont Town Health Officer Complaint Inspection Form
PDF template
A standardized form for documenting health-related complaints and property inspections by local town health officers in Vermont.
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Complaint Form For Filing A Protected Disclosure Of Improper Governmental Activities AndOr Significa
PDF template
A form for employees or applicants to report improper governmental activities or significant health and safety threats.
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Youth Sports Medical History Form
PDF template
A comprehensive medical history form for youth sports participants, requiring detailed health information and medical practitioner verification.
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Employee Organization Leave Request And Reimbursement Form
PDF template
A form for public employees to request organization leave and reimbursement for specific meetings and circumstances.
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Employee Of The Month Nomination Form
PDF template
A form for nominating Jackson County employees for monthly recognition with specific eligibility criteria and rewards.
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Employer Of Record Time Sheet
PDF template
A timesheet form for tracking employee hours and services, particularly for respite care services.
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FacultyStaff Voluntary Payroll Deduction Form For Tax Deductible Donations To The EOU Foundation
PDF template
A form for faculty and staff to set up voluntary monthly payroll deductions for donations to the EOU Foundation
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Law Enforcement Officers Waiver Form
PDF template
Form for Law Enforcement Officers to waive enrollment privileges in the Public Employees' Retirement System (PERS)
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EPAR Timesheet
PDF template
A standard timesheet form for tracking employee work hours and payroll information.
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TIME OFF REQUEST FORM
PDF template
A form for employees to request vacation, sick, personal, or flex time with specific instructions and approval process.
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OMNI EPerformance Training AP EPerformance Quick Reference Supervisor And Employee Actions
PDF template
A step-by-step guide for supervisors and employees using the ePerformance evaluation system for performance reviews.
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Nomination And Declaration Form For Unexempted Exempted Establishments
PDF template
A form for employees to nominate beneficiaries for provident fund and pension scheme benefits in case of death.
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Employer Pension Guide
PDF template
Comprehensive guide for rejoining employees about pension scheme options and eligibility criteria in the Principal Civil Service Pension Scheme (PCSPS).
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EDUCATION PARTNERS IN COVENANT (EPIC) CONTRIBUTION FORM
PDF template
A form for congregations to provide financial support for students attending Luther College, with matching funds from the institution.
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Disposition Authorities Frozen Under The Epidemiological Moratorium
PDF template
Comprehensive list of disposition authorities for health-related records under moratorium at the Department of Energy as of March 2008.
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Episodic Medical Form
PDF template
A comprehensive medical intake form for students to document current health issues and medical history at Ramapo College's Health Services.
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COVID 19 Emergency Paid Leave (EPL) Employee Notification And Leave Request Form
PDF template
Form for employees to request emergency paid leave related to COVID-19 circumstances and qualifying conditions
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Kenyon College Employee Performance Program Guide For Supervisors
PDF template
A comprehensive guide outlining Kenyon College's performance management process, including quarterly check-ins and triennial performance reviews.
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Equipment And Personal Items Inventory Form
PDF template
A form used to document institutional assets and personal items being returned by an employee during separation from UT Health San Antonio.
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ERCS Kudos Corner Submission Form
PDF template
A form for employees to recognize and nominate colleagues for outstanding work in a monthly newsletter feature.
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College Of The Siskiyous Emergency Contact Form
PDF template
A form for collecting employee emergency contact information and contact preferences for information release.
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Employee Resource Document
PDF template
A comprehensive resource document for employees providing emergency contacts, academic information, and campus resources.
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ERFC Durable Power Of Attorney (Designation Of Agent For ERFC Matters)
PDF template
A legal document allowing a member to designate an agent to make retirement system-related decisions on their behalf.
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Retirement Checklist
PDF template
A comprehensive checklist for members preparing to retire, outlining key steps and document requirements one year before retirement.
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Federal And State Income Tax Withholding Form
PDF template
Form for new retirees to specify federal and state income tax withholding preferences for ERFC annuity payments.
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ElectricianS Retirement Fund Benefit Application Packet
PDF template
An application packet for pension benefits from the Electrician's Retirement Fund, providing instructions for submitting retirement documentation.
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Emergency Ride Home (ERH) Reimbursement Form
PDF template
Form for employees to request reimbursement for emergency transportation home under specific qualifying circumstances.
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Erie Gives Check Contribution Form
PDF template
A form for making check donations to nonprofit organizations through the Erie Community Foundation's Erie Gives program.
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NEW UPDATE IMPORTANT PAYROLL INFORMATION FOR ALL FACULTY AND STAFF
PDF template
Notification about the new PeopleSoft payroll system requiring all employees to submit time and leave requests electronically, eliminating traditional timecards and leave forms.
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ERS Pension Deduction Cancellation Form
PDF template
Form for retirees to cancel automatic health benefit premium deductions from their ERS pension
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RETIREE INSURANCE ENROLLMENT FORM
PDF template
A form for Texas Employees Retirement System retirees to enroll in insurance and provide Medicare information
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ES 4316 EES InterviewScreen
PDF template
A screening form to evaluate employee eligibility for intervention services based on multiple risk factors
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ESA 1126A FORFFA Cancellation Of Direct Deposit
PDF template
Official form for cancelling direct deposit for unemployment insurance benefits in Arizona
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Payroll Deduction Authorization Form For Panther Employee ScholarshipWaiver Program
PDF template
Authorization form for Prairie View A&M University employees to have tuition and fees deducted directly from their paycheck
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2012 OPERS Prescription Plan Guide
PDF template
Guide for OPERS health care plan participants explaining prescription drug coverage options for Medicare-eligible members
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ESP Performance Review
PDF template
A comprehensive evaluation form for assessing employee performance across multiple job characteristics and skills.
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Vehicle Registration Form
PDF template
A form for registering vehicles for employees at Vassar College, used to track campus parking and vehicle information.
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Report Of Transfer Or Multiple Enrollment
PDF template
A form for reporting membership transfer between public employee retirement systems with details about previous and new employment.
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EMPLOYEE TIME OFF REQUEST FORM
PDF template
A form for employees to request various types of time off, including sick leave, vacation, and bereavement
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Retirees Association Life Membership Contribution Form
PDF template
A form for retirees to make a non-refundable contribution to the ETSU Retirees Association Endowed Scholarship Fund.
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Retirees Association Scholarship Endowment Contribution Form
PDF template
A form for university retirees to make donations to a scholarship endowment supporting entering freshmen or transfer students with financial need.
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Feedback Form
PDF template
Survey collecting feedback from TV writers and producers about CDC resource materials and tip sheets for health-related storytelling.
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Carter County PERSONNEL PERFORMANCE REVIEW FORM
PDF template
A comprehensive form for evaluating employee performance across multiple job competency categories.
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Event Expense Reimbursement Form
PDF template
Form for reimbursing event expenses for approved sporting events at fire stations, with a $500 annual benefit maximum.
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Piercing Consent Release Form
PDF template
Legal document providing informed consent for body piercing procedures, detailing risks and patient acknowledgments.
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Volunteer Management Toolkit Health And Safety Information
PDF template
A comprehensive guide outlining health and safety responsibilities, reporting procedures, and expectations for volunteers in arts organizations.
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MEDICAL BENEFITS SUBSCRIBER CLAIM FORM
PDF template
A comprehensive medical insurance claim form for submitting healthcare reimbursement or coverage information.
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City Of Shelby Income Tax Exemption Form
PDF template
A form for retired individuals in Shelby, Ohio to claim income tax exemption for those with no taxable income.
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City Of Shelby Income Tax Exemption Form
PDF template
A form for retired individuals with no taxable income to request tax exemption from the City of Shelby, Ohio.
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Exercise Waiver And Release Form
PDF template
A legal document releasing fitness facilities or trainers from liability for potential injuries during exercise activities.
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Supervisor Safety Accident Report Form
PDF template
A comprehensive form for documenting workplace accidents, injuries, and recommended corrective actions.
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Exhibition Booking Form
PDF template
Booking form for virtual exhibition participants at the 5th High-level Ministerial Meeting on Transport, Health and Environment
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EXIT CHECKLIST
PDF template
A comprehensive form for employees to complete when leaving their position, covering key administrative and logistical tasks during the exit process.
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EMPLOYEE CLEARANCE CHECK LIST
PDF template
A comprehensive form for documenting an employee's departure from an organization, covering departmental clearance and separation details.
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Stephen F. Austin State University ADDRESSNAME CHANGE FORM
PDF template
A form for university employees to update personal information including name, address, and contact details.
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EXIT INTERVIEW FORM
PDF template
A comprehensive form tracking an employee's departure process, including benefits, equipment return, and final payroll details.
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G Adventures Confidential Medical Form
PDF template
A confidential medical form for travelers with pre-existing medical conditions to assess fitness for expedition travel.
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SEMA4 EMPLOYEE EXPENSE REPORT
PDF template
A form for employees to document and request reimbursement for travel-related expenses and mileage.
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EXPENSE REIMBURSEMENT PROCEDURES
PDF template
Comprehensive guidelines for employee expense reimbursement covering business expenses and travel, aligned with IRS accountable plan regulations.
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SEMA4 Employee Expense Report
PDF template
A comprehensive form for employees to report travel expenses, mileage, and other reimbursable costs for business trips.
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EXPENSE REPORT
PDF template
A form for employees to report and request reimbursement for work-related expenses, including travel and miscellaneous costs.
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SEMA4 Employee Expense Report
PDF template
A detailed form for documenting employee travel expenses, mileage reimbursement, and other related costs.
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Payroll Deduction Authorization Form
PDF template
Form for Florida International University (FIU) employees to authorize payroll deductions for summer camp registration and related services.
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Exposure Incident Investigation Form
PDF template
A form used to document and investigate workplace exposure incidents involving potentially infectious materials.
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Exposure Incident Investigation Form
PDF template
A detailed form for documenting and investigating workplace exposure incidents, including route of exposure, materials involved, and prevention recommendations.
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Express Benefit Report
PDF template
A form used to report accumulated unused sick leave balances and employment termination information for CalSTRS retirement benefits.
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EXTENDED LEAVE REQUEST FORM
PDF template
A comprehensive form for employees to request extended leave, including details about leave type, duration, and supporting documentation.
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Texas City ISD Extended Leave Request Form
PDF template
A form for employees to request extended leave with medical certification, to be submitted to Human Resources.
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Eyeglass Reimbursement Form
PDF template
A form for employees to request reimbursement for eyeglass purchases through the school district's benefits program.
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EnrollmentChange Form
PDF template
A form for enrolling or changing employee and family insurance coverage with Fidelity Security Life Insurance Company.
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EnrollmentChange Form
PDF template
Insurance enrollment and change form for employees and their family members, underwritten by Fidelity Security Life Insurance Company.
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EyePAC Contribution Form
PDF template
A voluntary contribution form for supporting ophthalmic surgeons' political interests through eyePAC membership tiers.
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EyewashDrench Hose Weekly Inspection Form
PDF template
Weekly safety inspection form for verifying proper functioning and accessibility of emergency eyewash stations in a workplace or laboratory setting.
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EYEWASH SHOWER INSPECTION RECORD
PDF template
A monthly inspection record for eyewash stations and safety showers in laboratory settings to ensure proper functioning and emergency readiness.
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Eyewash Weekly Inspection Form
PDF template
Weekly safety inspection form for verifying emergency eyewash station functionality and accessibility in workplace environments.
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Direct Deposit Request Form
PDF template
Form for employees to request direct deposit of paycheck into bank account(s)
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Employer Health Insurance Verification Individual Follow Up Health Insurance Information
PDF template
A form for employers to verify health insurance benefits offered to employees and their families for BadgerCare Plus applicants.
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Change Of Address Form Benefit Recipient
PDF template
A form for benefit recipients to update their mailing address with the Massachusetts Teachers' Retirement System (MTRS)
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Change Of Address Form
PDF template
A form for members to update their mailing address for various trust fund communications and services.
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Wisconsin Medicaid Services Application
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Wisconsin state application form for Medicaid services, including applicant and spouse information, income details, and eligibility questions.
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Medicaid Asset Assessment
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A form to evaluate the total assets owned by a Medicaid applicant and their spouse to determine eligibility for Medicaid benefits.
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Authorization To Access TIAA Accounts
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A form for authorizing a person or organization to access and discuss TIAA account information on behalf of the account holder.
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TIAA BROKERAGE INCOMING ACCOUNT TRANSFER FORM
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A form for transferring assets between financial accounts, detailing instructions for incoming account transfers to TIAA Brokerage.
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Plan Sponsor Refund Request
PDF template
A form for plan sponsors to request refunds of contributions for retirement plans, with options for single or multiple participant refunds.
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Mistake Of Fact
PDF template
Form for plan administrators to request refund correction for arithmetic or clerical errors in participant contributions within one year of occurrence.
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Puget Sound Benefits Trust Short Term Disability Claim Form
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A comprehensive form for employees to file a short-term disability claim, requiring details from the employee, employer, and attending physician.
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NW Plumbers Pipefitters Health Fund Change Of Address Form
PDF template
A form for updating personal contact information for members of the NW Plumbers & Pipefitters Health Fund
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Medical Dental Vision Prescription Weekly Disability Claim Form
PDF template
Comprehensive claim form for medical, dental, vision, prescription, and weekly disability benefits for NW Plumbers & Pipefitters Health Fund members.
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Change Of Address Form
PDF template
A form for employees to update their contact information with the Puget Sound Electrical Workers Trust Funds.
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Enrollment Form F33
PDF template
Comprehensive enrollment form for employees to register dependents and update personal information for benefit plans
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REQUEST FOR A QUALIFIED CHARITABLE DISTRIBUTION (QCD) FROM A BROKERAGE RETIREMENT ACCOUNT (IRA)
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A form for requesting a tax-efficient charitable donation directly from an IRA account for individuals aged 70 or older.
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Disability Claim Form
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A comprehensive form for submitting a disability insurance claim, covering coverage information, work schedule, and earnings details.
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Change Of Address Form
PDF template
A form for union members to update their contact information with the trust funds administration office.
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Election To Withhold Federal Income Tax From Periodic Payments
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A form for participants to select federal income tax withholding preferences for periodic pension payments from the Pension Benefit Guaranty Corporation.
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Form WT 4A Worksheet For Employee Withholding Agreement
PDF template
A worksheet for employees to adjust their income tax withholding for 2015 in Wisconsin based on estimated tax liability.
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Change Of Address Form
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A form for employees to update their personal contact information with the Engineers-AGC Retirement Trust
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Western Metal Industry Pension Fund Pre Retirement Death Application
PDF template
A form for surviving spouses to apply for pension benefits after the death of a participant in the Western Metal Industry Pension Fund.
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Change Of Address Form
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A form for members of Steamfitters Local Union 602 to update their personal contact information for benefit funds records.
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REGISTRATION FORM Institute For Learning In Retirement
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Registration form for the Institute for Learning in Retirement, including course selections, parking pass, and volunteer opportunities.
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FAA Child Care Subsidy Program Monthly Invoice Form
PDF template
A form for FAA employees to submit monthly child care service costs and receive subsidy reimbursement.
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FAA Student Coaching And Feedback Form
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A documentation form for supervisor-employee conversations regarding performance coaching and feedback at the FAA.
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One E App Health E Arizona
PDF template
An electronic application system for assistance programs supported by One-e-App software, used by FAA, AHCCCS, and authorized organizations.
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Appendix 1 To FAA NATCA FFCRA MOU
PDF template
A document for employees to request emergency leave related to COVID-19 under the Families First Coronavirus Response Act.
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Supplemental Annuity Collective Trust Of New Jersey (SACT)
PDF template
A voluntary investment program providing retirement income supplemental to basic pension plans, with two tax-treatment options for public employees in New Jersey.
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Faculty Assembly (FA) Payroll Deduction Form
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A form for faculty members to authorize payroll deductions for the Faculty Assembly contributions for fiscal year 2015/16.
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Faculty Staff Campaign Payroll Deduction
PDF template
A form for Anna Maria College employees to authorize payroll deductions for charitable giving to the institution.
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Faculty And Staff Contribution Form
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A form enabling faculty and staff to make financial contributions to various university funds and programs through cash, check, credit card, or payroll deduction.
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Payroll Deduction Form
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A document allowing employees to authorize monthly or one-time payroll deductions for university donations and support various campus programs and funds.
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FacultyStaff Payroll Deduction Form
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A form for faculty and staff to make charitable donations to Metro State University through payroll deductions or other payment methods.
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FacultyStaff Payroll Deduction Form
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A form for Widener University faculty and staff to set up recurring or one-time payroll donations to university funds.
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Fair Hearing Request Form
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A form for appealing MassHealth decisions and requesting a fair hearing to challenge agency actions or inactions.
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Westtown Township Health And Fitness Registration And Insurance Form
PDF template
Registration form for fitness programs with health history and medical information collection
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Fall 2023 Veterans Education Benefits Enrollment Form
PDF template
A form for veterans to enroll and verify educational benefits and student status at the University at Buffalo for the Fall 2023 term.
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Emergency Sick Leave Request
PDF template
A form for employees to request emergency sick leave due to COVID-19 related reasons between April 1 and December 31, 2020.
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Family And Medical Leave Request Form
PDF template
A comprehensive form for employees to request unpaid family and medical leave under federal FMLA guidelines, detailing leave entitlements and notice requirements.
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Family Camp Medical Form
PDF template
Medical form for capturing health details and emergency contact information for families attending a camp
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Family Contribution
PDF template
A document used to verify and document financial contributions from a provider to an applicant or participant.
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ELIGIBILITY AND BILLING FORM
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Form for qualifying for corporate and family education benefits at DeVry University, detailing eligibility requirements and student/employer information.
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Family Emergency Plan
PDF template
A comprehensive document for recording family medical details, emergency contacts, and critical health information for emergency preparedness.
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NECAIBEW Family Medical Care Plan Family Enrollment Form
PDF template
An enrollment form for employees to enroll in the NECA/IBEW Family Medical Care Plan, including personal, spousal, and dependent information.
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Family Medical History Form
PDF template
A comprehensive form for documenting family medical history across multiple health conditions and genetic risks.
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Family Medical Leave Request Form
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A form for Rappahannock County Public Schools employees to request family or medical leave with required documentation from healthcare providers.
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APPLICATION FOR GRANT OF FAMILY PENSION
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Application form for requesting family pension benefits from Bank of Baroda Pension Fund Trust after the death of a pensioner.
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Educational Benefit Tax Exemption Frequently Asked Questions
PDF template
A guide explaining tax implications and procedures for educational assistance benefits through UET (University/Employer Training) program.
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FAQs CVS Caremark Pharmacy Transition
PDF template
Frequently asked questions about prescription drug benefits transition from Medco to CVS Caremark for PERS Select/Choice/Care members.
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Dual Benefits Reimbursement Form
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A form for open-shop contractors to request reimbursement for employer-sponsored benefit plan contributions while working on City of Seattle projects.
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Retiree Enrollment Form
PDF template
Enrollment form for Fulton County retirees to select health and dental plan coverage options and update personal information.
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STATEMENT OF FACTS SUPPORTING ELIGIBILITY FOR AFDC FOSTER CARE(FC)
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California state form documenting a foster child's eligibility for AFDC-Foster Care benefits and personal information.
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LSU Faculty Dental Practice Medical History Form
PDF template
Comprehensive medical history form for patients at LSU Faculty Dental Practice, collecting personal health information and medical background.
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Claim For Dismemberment Benefits
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A federal employee insurance claim form for documenting loss of limb or eyesight benefits under the Federal Employees' Group Life Insurance Program.
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Tax Withholding Form For Pension And Annuity Payments
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A form for U.S. citizens to specify federal and state tax withholding preferences for pension and annuity payments
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Form W 4P (2020)
PDF template
A form for pension recipients to specify their desired federal tax withholding amount from retirement allowance payments.
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Form W 4P Withholding Certificate For Pension Or Annuity Payments
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Form for pension recipients to specify federal tax withholding preferences for retirement allowance payments.
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Pension Federal Tax Withholding Form
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Form for pension or annuity recipients to request voluntary federal income tax withholding from their monthly payments
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Health Benefits Claim Form
PDF template
A comprehensive form for submitting health insurance benefits claims, including patient and insurance information.
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FAMILIES FIRST CORONAVIRUS RESPONSE ACT LEAVE REQUEST FORM
PDF template
Form for employees to request leave under the Families First Coronavirus Response Act for COVID-19 related reasons
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Leave Request Form Families First Coronavirus Response Act Employee Paid Leave
PDF template
A form for employees to request paid or unpaid leave under the Families First Coronavirus Response Act (FFCRA) during the COVID-19 pandemic.
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Families First Coronavirus Response Act (FFCRA) Leave Request
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Form for employees to request paid sick leave and expanded family medical leave related to COVID-19 pandemic
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COVID 19 LEAVE REQUEST FORM
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A form for employees to request leave due to COVID-19 related reasons under the Emergency Paid Sick Leave Act.
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FAMILIES FIRST CORONAVIRUS RESPONSE ACT (FFCRA) LEAVE REQUEST FORM
PDF template
A form for employees to request paid leave under the Families First Coronavirus Response Act for various COVID-19 related reasons.
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Preparticipation Physical Evaluation Medical History Form
PDF template
Comprehensive medical history form for students participating in sports, requiring detailed health information and medical evaluation
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Medical History Form
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Comprehensive medical history and health screening form for student-athletes to assess fitness for sports participation
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Presbytery Of Carlisle Contribution Form
PDF template
A financial contribution form for churches to allocate funds to various presbytery projects, special offerings, and appeals.
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UHC WTIA (EnrollCancelWaiverChanges)
PDF template
A comprehensive form for employees to enroll, modify, or cancel health insurance benefits and personal information.
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Central Ohio Retired Firefighters 4 Unit Membership Application
PDF template
Membership renewal form for retired firefighters and their families in the Central Ohio region, with dues and optional purchases.
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YMCA Camp Independence 2024 Health History And Examination Form
PDF template
Medical form for collecting camper health information and emergency contact details for YMCA summer camp participation.
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Withdrawal Form
PDF template
Instructions and form for withdrawing funds from a retirement account, including required documentation and submission methods.
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AccidentIncident Report Form
PDF template
A comprehensive form for documenting workplace accidents, incidents, and related details for reporting and prevention purposes.
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Change Of Address Notice
PDF template
Official form for updating member contact information with the New York City District Council of Carpenters Benefit Funds.
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Confidentiality Agreement
PDF template
A comprehensive confidentiality agreement outlining information protection requirements for employees and contractors of A & T.
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Direct Deposit Form For NYS Employees
PDF template
A form for New York State employees to set up, modify, or cancel direct deposit of their salary into bank accounts.
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Redemption Chapel Payroll Direct Deposit Form
PDF template
A form for employees to provide bank account details for direct deposit of payroll earnings.
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DOTM FORM 1024 FFCRA SICK LEAVE REQUEST
PDF template
A form for employees to request paid sick leave under the Families First Coronavirus Response Act (FFCRA) during the COVID-19 pandemic.
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Loan Application Form
PDF template
A loan application form for University of the Philippines employees with different loan amount limits based on employee classification.
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Employee Handbook
PDF template
Comprehensive guide detailing company policies, employee benefits, conduct expectations, and workplace guidelines for employees.
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Medical Report Health Statement And Immunizations For 2023 2024
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Medical form for documenting student health status and required immunizations for St. Paul's School enrollment
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MEDICAL HISTORY FORM
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Comprehensive medical history form for capturing patient health information, medical conditions, lifestyle factors, and current health concerns.
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Medical Information Form
PDF template
A comprehensive medical form for students to provide health information, medication details, and parental consent for school medical procedures.
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Naturopathic Patient Intake Form
PDF template
Comprehensive intake form for new patients seeking naturopathic medical consultation, collecting detailed personal and health history information.
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Osteopathy Patient Intake Form
PDF template
Comprehensive medical intake form for osteopathic patient assessment and medical history documentation.
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Sick Leave Request Form
PDF template
A form for employees to request sick leave and associated pay, to be processed by the payroll department.
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TIME OFF REQUEST FORM
PDF template
A form for employees to request time off for various reasons including vacation, sick leave, or personal reasons.
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Paths To Health NM Tools For Healthier Living Referral Form
PDF template
A referral form for participants to join Paths to Health NM health programs with provider contact information.
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Finance Forum Notes
PDF template
Internal meeting notes covering student employment I-9 process, IT training, year-end fiscal activities, and department invoicing procedures.
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Mansfield Independent School District Business Procedures Manual, Section 6 EmployeeStudent Travel
PDF template
Detailed guidelines for travel expenses, reimbursement, and approval process for Mansfield Independent School District employees and students.
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Type 2 Diabetes Risk Assessment Form
PDF template
A comprehensive questionnaire to assess an individual's risk of developing type 2 diabetes within the next 10 years.
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FinlandS Response To Questionnaire On Social Protection Of Older Persons
PDF template
Comprehensive document detailing Finland's legal framework for pension and social protection systems for older persons, covering national and employment-based pension schemes.
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First Aid Policy
PDF template
A comprehensive policy outlining first aid requirements, responsibilities, and procedures for ensuring health and safety in school settings.
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COVID 19 Paid Sick Leave Act Request Form
PDF template
Form for employees to request paid sick leave due to COVID-19 quarantine or isolation orders in New York State.
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Employee Voluntary Payroll Deduction Authorization For Fitness Center Usage Fee
PDF template
Voluntary authorization form for employees to have fitness center usage fee deducted from their paycheck
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Payroll Deduction For Fitness Center Membership
PDF template
A form for employees to authorize payroll deductions for fitness center membership at Clayton State University.
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Management Benefits Fund (MBF) Health And Fitness Reimbursement Program Claim Form
PDF template
A form for MBF members to claim reimbursement for health and fitness expenses for themselves and their spouse/domestic partner.
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Payroll Deduction Form For The SSU Employee Fitness Plan
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Form for faculty and staff to enroll in Savannah State University's fitness plan with payroll deduction options.
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2024 Fitness Reimbursement Program
PDF template
A program offering up to $300 per family annually for eligible fitness expenses for University System of New Hampshire employees and dependents.
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HealthFitness Center Reimbursement Form
PDF template
A form for Capital Health Plan members to request reimbursement for health and fitness center memberships up to $150 per family or member.
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Standard Immunization Requirements For Admission To U.S. Schools
PDF template
A comprehensive medical form documenting vaccination history and requirements for students entering U.S. schools or programs
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PF 132 (10 18) SUNY Reimbursement Accounts Enrollment Form
PDF template
Form for employees to enroll in health care and dependent care flexible spending accounts with pre-tax payroll deductions.
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Direct Deposit Authorization
PDF template
A form for employees to authorize direct deposit of payments or reimbursements with bank account details.
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Reimbursement Form For Flexible Spending Account (FSA)
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Form for employees to request reimbursement for healthcare and dependent care expenses through a Flexible Spending Account.
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MEDICAL FLEX REIMBURSEMENT FORM
PDF template
A form for employees to request reimbursement for medical and dental expenses through a flexible spending account program.
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BESTflex Plan Election Form
PDF template
Document for employees to elect participation in flexible spending accounts for healthcare and dependent care expenses
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Basilica Of St. Mary Flower Contribution Form
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A form for making floral contributions to support the Basilica of St. Mary's altar flower arrangements and liturgical decorations.
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Flu Vaccine Form
PDF template
A comprehensive form for patient consent and medical screening prior to receiving a flu vaccine.
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Informed Consent To Body Pierce
PDF template
Legal form for obtaining patient consent and documentation for body piercing procedures in Wisconsin.
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FM EXP TravelAuthorizationForm 001
PDF template
A form for obtaining prior authorization for out-of-state or out-of-country employee travel with specific conditions and usage guidelines.
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FAMILY MEDICAL LEAVE EMPLOYEE LEAVE REQUEST FORM
PDF template
A form for employees to request medical or family leave under FMLA and NJFLA regulations, documenting eligibility and reasons for leave.
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City Of Round Rock Request For FMLA Leave
PDF template
Official document for City of Round Rock employees to request Family and Medical Leave Act (FMLA) leave for various personal and family health situations.
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Leave Request Form Federal COVID 19 FFCRA
PDF template
A form for employees to request paid leave under the Families First Coronavirus Response Act (FFCRA) for COVID-19 related reasons.
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FAMILY MEDICAL LEAVE (FMLA) REQUEST FORM
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A form for employees to request Family and Medical Leave Act (FMLA) leave for various qualifying reasons including personal or family medical conditions, birth, adoption, or military-related leave.
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FAMILY OR MEDICAL LEAVE REQUEST FORM
PDF template
A form for employees to request family or medical leave for various personal and family health-related reasons.
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FMLA LEAVE REQUEST FORM
PDF template
A form for employees to request leave under the Family and Medical Leave Act for various personal and family health-related reasons.
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Family And Medical Leave (FML)Paid Parental Leave (PPL) Request Form
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A form for employees to request family and medical leave or paid parental leave, including various qualifying reasons for absence.
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Family Medical Leave Request Form (FMLA)
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Form for employees to request Family and Medical Leave for various personal and family health-related reasons.
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FNIS Request Form
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Form for nonresident employees and students to provide immigration and personal information for tax withholding purposes at Northwestern University.
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FNS 415 Interviewing
PDF template
Guidelines for conducting interviews for Food and Nutrition Services benefit applications, outlining interview requirements and interviewer responsibilities.
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Food And Nutrition Services Certification Applications FNS 415 Interviewing
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Guidelines for conducting interviews for Food and Nutrition Services benefits application process, detailing interview requirements and interviewer responsibilities.
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JANDAKOT AIRPORT HOLDINGS HAZARD REPORT FORM
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A form for reporting safety hazards and potential risks at Jandakot Airport, used by tenants, employees, and visitors to document safety concerns.
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U.S. BANK FOCUS CARD Enrollment Form
PDF template
Enrollment form for obtaining a U.S. Bank Focus Card with personal and employment information collection
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Food Delivery Checklist
PDF template
Comprehensive checklist for state agencies managing WIC food delivery systems, vendor management, and food benefit distribution.
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Food Establishment Inspection Report
PDF template
Official inspection report for evaluating food service establishments' compliance with health and safety regulations.
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Food Label Approval Form
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A form used by the Rhode Island Department of Health for reviewing and approving food product labels.
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FOOT Medical And Insurance Form
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Medical and insurance form for participants in the Yale First-Year Outdoor Orientation Trips (FOOT) program, collecting health and emergency contact information.
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FOOTWEAR SELECTION AND PROCUREMENT PROCEDURE
PDF template
Procedure for selecting and procuring protective footwear for employees with safety requirements and reimbursement guidelines.
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Foreign Change Of Address Form
PDF template
Form for updating international employee address and tax document delivery preferences at the University of Pittsburgh.
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Foresight Carrier Screen Requisition Form
PDF template
A medical form for requesting genetic carrier screening, collecting patient and clinic information, and processing billing details.
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Termination Refund Application
PDF template
A form for APERS members to request a termination refund with options for direct deposit or rollover of retirement benefits.
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Termination Refund Application
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A form for members to request a refund of retirement contributions upon termination of employment with options for direct deposit or rollover.
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PBGC Form 10 Post Event Notice Of Reportable Events
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A form for reporting significant events related to pension plans that may impact plan participants and financial stability.
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Form 11 LEAVE REQUEST FORM
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A form for employees to request various types of leave, including vacation, sick, and compensation time, with supervisor approval.
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LASER DEVICE REGISTRATION FORM
PDF template
Official form for registering laser devices with the Florida Department of Health Bureau of Radiation Control.
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Health And Immunization Form
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Comprehensive health form required for all undergraduate students detailing medical history, immunizations, and emergency contact information.
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Inquiry To Become Contributory
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Form for Arkansas Teachers' Retirement System members to initiate the process of changing their membership status from Noncontributory to Contributory.
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Johnson Wales University Health Services Requirements
PDF template
Comprehensive health documentation and vaccination requirements for new students enrolling at Johnson & Wales University
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Interactive Brokers LLC Customer Agreement Individual Retirement Account
PDF template
Legal agreement establishing an individual retirement account with Interactive Brokers and Equity Trust Company, outlining terms of account management and customer responsibilities.
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Change Of Address Form RetireesBenefit Recipients
PDF template
Official form for updating personal contact information for retirees and benefit recipients of Arkansas Retirement System.
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Individual Unemployability (IU Or TDIU) Intake Form
PDF template
A comprehensive intake form for veterans seeking total disability benefits based on individual unemployability due to service-related medical conditions.
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FORM 68 EMPLOYEE DISCIPLINARY ACTION FORM
PDF template
A formal document used to record and document employee workplace violations and disciplinary actions.
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Dependency And Indemnity Compensation (DIC) Intake Form
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A form for surviving spouses, children, or dependent parents to apply for monthly compensation based on a veteran's service-connected death or disability.
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Acceptance Of Site Specific Health And Safety Plan (SSHASP) Form
PDF template
Internal form for documenting compliance and acceptance of a contractor's site-specific health and safety plan by an NJSDA Field Compliance Inspector.
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Energy Assistance Program Change Of Address Form
PDF template
Form for updating contact and utility information when moving to a new address while receiving energy assistance benefits.
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Alaska Travel Declaration Form
PDF template
Required form for travelers entering Alaska, documenting health status and travel details during COVID-19 pandemic.
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Health Exam Form B
PDF template
A medical form for student athletes to obtain health clearance for participation in school athletic activities in Utah.
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SEIU Michigan Health And Welfare Fund MemberS Change Of Address Form
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A form for SEIU Michigan Health and Welfare Fund members to update their personal and employment information.
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Contribution Form
PDF template
A tax-deductible contribution form for making monetary donations to Maryland University of Integrative Health with multiple designation options.
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Commonwealth Of Massachusetts EMPLOYEE REIMBURSEMENT FORM
PDF template
A form for Massachusetts state employees to submit expenses and mileage for reimbursement, including private auto mileage, meals, fares, and other expenses.
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FMLA LEAVE REQUEST FORM
PDF template
A form for employees to request family or medical leave, documenting leave details and employee information.
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Contribution Form
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A form for making contributions to The Arc of Texas Master Pooled Trust, used by beneficiaries or their representatives.
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Maryland Schools Record Of Physical Examination
PDF template
Document outlining physical examination, immunization, and blood lead testing requirements for students entering Maryland public schools.
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COVID 19 LEAVE REQUEST FORM
PDF template
A form for employees to request leave related to COVID-19 situations and circumstances
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Permanent Mailing Address Form
PDF template
A comprehensive form for collecting personal and professional information for employment and retirement system membership in Ohio
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2022 Health Savings Account Payroll Deduction Form
PDF template
Form for employees to authorize payroll deductions for Health Savings Account (HSA) contributions in 2022.
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Accident Investigation Form (Example 2)
PDF template
A comprehensive form for documenting and investigating workplace accidents, collecting details about the incident, affected employee, and supervisor's assessment.
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Physical Examination Form
PDF template
Medical form for students at American School of Warsaw to document health status and medical clearance for school attendance and sports participation.
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Employer Sponsored Program How To File A Claim For Approval
PDF template
Comprehensive guide for employees on submitting claims through a healthcare benefits platform with detailed filing instructions and documentation tips.
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Medical History Form
PDF template
Required medical history form for students living on campus or participating in sports, documenting health conditions and physical readiness.
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Nebraska FBLA Medical Release Form
PDF template
Medical consent and emergency information form for FBLA chapter members, providing authorization for medical treatment and contact details.
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NYPD Retirees Handgun License Application Instructions
PDF template
Detailed instructions for New York City Police Department retirees applying for a handgun license upon retirement.
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Planning And Evaluation Form
PDF template
A comprehensive form for documenting employee performance goals, objectives, and achievements for an annual performance review cycle.
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Physical Examination
PDF template
A comprehensive medical examination form for girls participating in multi-day trips, documenting health status and medical clearance.
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Prior Service Certification Form
PDF template
Form for employees to request prior service credit from previous Ohio state agency employment
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IBEW LOCAL NO. 461 VARIABLE PENSION PLAN REQUEST FOR APPLICATION FORM
PDF template
A form for IBEW Local No. 461 members to request pension benefits, including normal retirement, early retirement, or total and permanent disability benefits.
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IBEW LOCAL NO. 32 NECA PENSION PLAN REQUEST FOR APPLICATION FORM
PDF template
A form for requesting pension benefits from the IBEW Local No. 32 NECA Pension Plan, allowing participants to apply for various retirement options.
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Plumbers And Pipefitters Local 333 Pension Fund Request For Application Form
PDF template
A form for requesting a pension application for members of Plumbers and Pipefitters Local #333 Pension Fund seeking retirement benefits.
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Form R Retiree Request Form
PDF template
A form for FedEx retirees to request travel tickets for themselves and eligible dependents using travel benefits.
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Prescription Drug Reimbursement Coordination Of Benefits Claim Form
PDF template
A form for submitting prescription drug reimbursement claims with details about medication, pharmacy, and patient information.
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In Processing Forms Checklist
PDF template
Comprehensive checklist for new federal employees joining the Federal Retirement Thrift Investment Board (FRTIB) to complete required employment and benefits documentation.
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Messiah University Form Collection
PDF template
A comprehensive list of administrative forms used across various departments at Messiah University for different financial and administrative purposes.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal and health information for medical treatment purposes.
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Change Address
PDF template
Guide for employees to update personal information and manage insurance-related documentation
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Workplace Complaint Form
PDF template
A form for filing workplace complaints by employees at a university medical center, detailing procedures for submitting grievances through Employee and Labor Relations.
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Cash Contribution Form
PDF template
A donation form for making financial contributions to Ridgewater College Foundation with various gift designation options.
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Contribution Form
PDF template
A charitable donation form for contributing to various healthcare-related funds and programs at Stormont Vail Foundation.
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Contribution Form
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Contribution Form
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A donation form for contributing to the Pennsylvania Chamber of Business and Industry Educational Foundation, a 501(c)(3) organization.
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Southern State Community College Employee Contribution Form
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A form for employees to make charitable contributions to the Southern State Community College Foundation through payroll deduction or direct payment
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Gift Authorization Form Employee Payroll Deduction
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Employee Donation Payroll Deduction Form
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Employee Payroll Deduction Pledge Form
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A form allowing employees to authorize recurring payroll deductions for charitable donations to the college foundation.
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Payroll Deduction AuthorizationChange Form
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A form for Pierce College employees to authorize payroll deductions for charitable donations to the Legacy of Excellence Fund.
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Payroll Deduction Form
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A form for employees to enroll or modify payroll deductions for university foundation donations.
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PATIENT INTAKE FORM
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Comprehensive medical history and current health status form for patient therapy intake and medical assessment.
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Employee Performance Review
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A comprehensive form for assessing employee performance across multiple professional competencies and skills.
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Employee Performance Review
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A comprehensive document for assessing employee job performance across multiple professional competencies and behaviors
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Time Off Request Form
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A form for employees to request and record time off from work, requiring supervisor and manager approval.
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Frequently Asked Questions For Tuition Benefit
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Comprehensive guide explaining application process, deadlines, and details for tuition benefit programs at Augsburg University and partner institutions.
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Time Off Request Form Hourly
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Inmate Medication Information Form
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Enrollment Form
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Comprehensive enrollment form for fringe benefits including health care, life insurance, and retirement plans for carpenters in Western Washington.
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Spousal Bypass Trust Form FRPF10292
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A legal document allowing scheme members to direct death benefits to a Spousal Bypass Trust for flexible distribution to dependants and beneficiaries.
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FAMILY FIRST CORONAVIRUS RESPONSE ACT (FFCRA) OREGON FAMILY LEAVE ACT (OFLA) LEAVE REQUEST FORM
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A form for employees to request leave under FFCRA and OFLA due to COVID-19 related circumstances
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Public Safety Officers Benefits (PSOB) Program History
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Document detailing the history and purpose of the Public Safety Officers' Benefits Act, which supports law enforcement and firefighter recruitment and retention.
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Supplemental Annuity Collective Trust (SACT) Personal Contribution Form
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A form for members to make personal contributions to the New Jersey Supplemental Annuity Collective Trust through check or money order.
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Section 125 Flexible Benefit Plan Direct Deposit Form
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A form for employees to authorize direct deposit of flexible benefit plan funds to a designated bank account.
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FSA Dependent Care Reimbursement Form
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A form for submitting dependent care expenses for reimbursement through a flexible spending account.
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Flexible Spending Accounts (FSA) Program EnrollmentChange Form
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Form for enrolling in or changing Health Care Flexible Spending Account (HCFSA) or Dependent Care Assistance Program (DeCAP) for Plan Year 2023
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2024 Flexible Spending Account EnrollmentChange Form
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Enrollment Form Flexible Spending Account(S)
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Recurring Claim Form
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A form for employees to automate reimbursement of qualified expenses with fixed payments to a service provider.
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Discrimination Complaint Form
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Form for reporting discrimination complaints by students, employees, or other individuals within the college community.
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Faculty And Staff Contribution Form
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A form for faculty and staff to make financial contributions to various university programs and funds.
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Fit Strong Data Collection Checklist
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Comprehensive checklist for leaders to manage Fit & Strong! workshop registration, participant tracking, and data collection processes.
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Fraser Street Medical Clinic New Patient Registration Form
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Comprehensive medical intake form for new patients collecting personal information, medical history, and current health symptoms.
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Virginia Tech Employee Software Sales Order Form
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A form for Virginia Tech employees to purchase software licenses and technology accessories at discounted rates.
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Pension Application Form
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An application form for becoming a member of the Future Super Pension Plan, collecting personal and tax information from prospective pension fund members.
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Medical Release For Training Programs
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Policy outlining medical clearance requirements for students participating in firefighter training programs with strenuous activities.
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Equity Contribution For Residential Mortgage
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Form for capturing personal and mortgage details for equity contribution to a residential mortgage application
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Full Time Member Membership Application Prior Service Purchase Form
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A form for Alabama retirement system members to purchase prior years of creditable service within the first two years of enrollment.
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PENSION BENEFIT APPLICATION FORM
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A comprehensive pension benefit application form for members to provide personal, marital, and employment information to determine benefit entitlement.
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Fund Contribution Form
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Donation form for making financial contributions to Charities Aid Foundation of America, including donor details and gift information.
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Fund Eligibility And Membership Section
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Document outlining eligibility requirements, enrollment procedures, and membership terms for a health insurance fund covering active and retired employees.
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Funeral Benefit Application Form
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Application form for claiming funeral benefits through the JLT (CSI Member Benefits) Discretionary Trust
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ORGANIZATION OF STAFF ANALYSTS FURLOUGH SURVEY FORM
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Survey form for staff members to indicate interest in taking a voluntary leave of absence with potential health benefit considerations.
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FURLOUGH SURVEY FORM
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Survey form for staff analysts to indicate interest in taking a leave of absence with health benefit conditions.
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FY13 Annual Report Form
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Annual report documenting University Information Services (UIS) activities, accomplishments, and strategic alignment for fiscal year 2013.
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Nonprofit Leadership Alliance Fiscal Year 2018 Board Of Directors Campaign Contribution Form
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A donation form for board members to contribute financially to the Nonprofit Leadership Alliance's mission of strengthening the social sector workforce.
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Organizational Membership Form
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Form for organizations to become members of MAPS with different membership levels and benefits
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Request For Proposals For Real Estate And Real Asset Investment Consultant Services
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Request for proposals from qualified firms to provide real estate investment consulting services to the Teachers' Retirement System of Illinois.
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Benefits Open Enrollment Form 2020
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Form for employees to select or modify healthcare coverage options and provide personal information for benefits enrollment.
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REQUEST FOR PROPOSALS FOR SECURITIES LITIGATION MONITORING, EVALUATION, AND REPORTING SERVICES
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Request for proposals from vendors to provide securities litigation monitoring, evaluation, and reporting services for the Teachers' Retirement System of Illinois.
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Program Solicitation Sound Health Network
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Grant proposal guidelines for a program exploring connections between music, neuroscience, and health research and wellness
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Form G 615 (06 19) EmployerS Supply Requisition
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DR 1 Disability Benefit Application
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Gannon University Health Examination Form
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A comprehensive health form required for students to access university health services and on-campus housing at Gannon University.
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Summary Plan Description
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A summary document detailing the retirement savings plan for Gannon University employees, explaining plan features, benefits, and participant obligations.
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Time Off Request Form
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A form for employees to request personal or sick time off, with details about coverage and documentation.
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PATIENT MEDICAL HISTORY FORM
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Comprehensive medical history form for patients at Gateway ENT to collect personal health information, medical history, and family health background.
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YMAHE Health Assessment Form
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Comprehensive health assessment form for first-year students requiring medical history, vaccination records, and physical examination details.
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General Inquiry Form
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A form for individuals to submit questions or issues related to Medicaid services and benefits.
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Request For Leave Of Absence Form
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A comprehensive form for employees to request leave of absence for various personal and family reasons, including documentation requirements.
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Bridge To Wellness Wellbeing Program General Medical Form
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A form for employees to document preventative medical, dental, eye, and dermatology examinations for a workplace wellness program.
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GeneralOffice Inspection Checklist
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A comprehensive checklist for periodic workplace safety and facility inspection covering general office conditions and potential hazards.
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NatWest Mentor Services General Risk Assessment Form
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Risk assessment document for Covid-19 workplace safety at NatWest Mentor Services Main Building
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GENERAL CLAIM SUBMISSION FORM
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A comprehensive form for submitting insurance claims with sections for member information, coverage details, and claim specifics.
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University Health Report
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Comprehensive health form for Northeastern University students requiring vaccination documentation and personal health information
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General Assessment Form
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A comprehensive form assessing patient's sleep, mental health, work performance, chronic condition management, and medication adherence.
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MEDICAL HISTORY AND RELEASE FORM
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Medical history and consent form for DeMolay participants under 21 years of age, including health history and liability release.
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Genesis Contribution Form
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A donation form for contributing to various patient care programs and services at Genesis HealthCare System.
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Personal Vehicle Use Form
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Form documenting employee personal vehicle usage and insurance details for official district business and field trips.
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Make Sure You Receive Your Retirement Benefits On Time
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A guide for managing the transition to pension payments, focusing on documentation and timing for retirement benefits from the Government Employees Pension Fund.
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New Patient Intake Form
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Comprehensive medical intake form for new chiropractic patients, collecting personal information and detailed health history.
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Employer Notice Of Claim Long Term Disability
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A comprehensive claim package for employers to submit long-term disability claims for employees, including detailed instructions and employee information sections.
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Short Term Disability Claim Form
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A form for employees to file a claim for short-term disability benefits, documenting medical leave and disability details.
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Pre Participation Physical Evaluation History Form
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Official medical evaluation form for student-athletes participating in Georgia high school sports, detailing medical history and physical examination requirements.
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Michigan Gastrointestinal Illness Complaint Interview Form
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A comprehensive form for documenting and investigating gastrointestinal illness complaints, patient information, and medical details.
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Gift Contribution Form
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A donation form for contributing to various funds within the Virginia Tech College of Veterinary Medicine
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Gift In Kind Acceptance Form
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A form for documenting and processing non-monetary donations to the university foundation, with specific instructions for submission and documentation.
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Gift In Kind Contribution Form
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A form for documenting non-cash donations to a university, including details for tax and record-keeping purposes.
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GIFT IN KIND CONTRIBUTION FORM
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A form for documenting non-cash donations to California State University Stanislaus Foundation
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Gift In Kind Contribution Form
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A form for documenting and reporting non-cash donations to the NCCU Foundation with tax guidance for donors.
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IN KIND CONTRIBUTION FORM
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A form for donors to document non-monetary contributions to the Judson Center non-profit organization.
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Gift In Kind Contribution Form
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Form for documenting and recording in-kind contributions to the NCCU Foundation with tax guidance for donors.
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GIFT IN KIND CONTRIBUTION FORM
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Form for documenting non-monetary donations to the Chattahoochee Tech Foundation, capturing donor details and contribution information.
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Payroll Deduction Form For Charitable Contributions To The University Of California, Santa Barbara
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A form allowing employees to set up monthly charitable contributions to the UCSB Foundation's Sustainable Transportation Fund through payroll deduction.
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Camper Medical Form
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Medical form for assessing a camper's health status, medical conditions, and fitness for camp participation.
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Health And Medical History Form
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A comprehensive medical history and health information form for American Heritage Girls members, valid for 12 months.
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Girl Scouts Contribution Form
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A fundraising form for individuals and corporations to make financial contributions to support Girl Scouts programs and mission.
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Girl Scouts Health History And Medical Examination Form For Minors
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Comprehensive medical and health history form for Girl Scout participants to capture essential health information and emergency contact details.
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Health History And Medical Examination Form For Minors
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Comprehensive medical form for collecting health information and medical history for Girl Scouts participants under 18 years old.
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Employee Payroll Deduction Form
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A form allowing employees to authorize recurring or one-time payroll deductions for various college funds and programs.
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Request For Benefits ClaimantS Report Of Loss
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A claim form for filing disability benefits for Glaziers, Architectural Metal and Glass Workers Local Union 1399 members.
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Short Term Disability Claim Form Statement Of Employee
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A comprehensive form for employees to file a short-term disability claim with detailed personal, employment, and medical information.
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Global Mamas Health Emergency Contact Form
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A comprehensive medical and contact information form for Global Mamas organization, collecting personal details and health history.
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GPLN Laboratory Submission Form
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Comprehensive form for submitting laboratory specimens related to poultry and avian health testing and research.
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GPTC Employee Complaint Resolution
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A procedure establishing a uniform process for resolving employment concerns and encouraging fair communication between employees and supervisors.
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Grateful Patient Contribution Form
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A form for patients to make tax-deductible contributions to support endodontic research, education, and awareness.
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GRIEVANT INTERVIEW FORM
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A detailed form for documenting and assessing employee grievances and potential contractual disputes.
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Employee GrievanceComplaint Form
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A formal document for employees to file workplace grievances or complaints through a structured escalation process.
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GRMC Foundation Contribution Form
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A tax-deductible donation form for supporting various fundraising categories at Gila Regional Medical Center Foundation.
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Insurance Information At Retirement
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Comprehensive guide for Illinois state employees regarding insurance eligibility, coverage, and options at retirement.
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Group Short Term Disability Claim Form
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A comprehensive form for filing a short-term disability insurance claim with Dearborn National, capturing employee medical and income details.
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SunAdvantage RRSPDPSPTFSA Sponsor Administration Guide
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A comprehensive guide for small business owners to manage employee group retirement and savings plans with minimal administrative effort.
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Payroll Delivery Form
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Form for employees to select their preferred method of receiving payroll payments, including direct deposit, pay card, or Western Union transfer.
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Girl Scouts Health History And Medical Examination Form For Minors
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Comprehensive health history and medical examination form for Girl Scout participants to document medical information and insurance details.
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Shared Sick Leave Request Form
PDF template
A form that allows Georgia Tech employees to request donated sick leave when they have exhausted their own paid leave due to serious health conditions.
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Accident Claim Form
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Insurance claim form for documenting student accident details and health information authorization
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Your Guide To Filing A Long Term Disability (LTD) Claim
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A comprehensive guide for filing a long term disability claim with Guardian, providing step-by-step instructions for completing the required forms and submission process.
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Guardian Life Insurance Enrollment Form
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Insurance enrollment form for University of Massachusetts Medical School employees to select benefits and coverage options.
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REQUEST FOR PROPOSALS Oracle Customer Cloud Service (CCS, OUAV, OUTA), Oracle Cloud Infrastructure (
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Request for competitive proposals for Oracle cloud system managed services and support for Greenville Utilities Commission.
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Guest Medical Information Form
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Confidential medical form for assessing guest fitness and suitability for an Antarctic expedition, collecting comprehensive health history.
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GUILD TIMES ADJUSTABLE PENSION PLAN
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Summary plan description for a pension plan covering employees of The Times and Guild - Local 31003/TNG union members.
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Medical History Form
PDF template
A comprehensive form for collecting patient medical history, health details, and emergency contact information for dental service purposes.
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Gym Reimbursement Form
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A form to help employees get reimbursed for fitness facility memberships and track workout sessions.
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2016 Haiti Mission Trip Payroll Deduction Form
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A form for employees of Morehouse School of Medicine to make a financial contribution to a Haiti Mission Trip through payroll deduction or direct payment.
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Contribution Form
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A donation form for making financial contributions to Halcyon, with options for payment frequency and method.
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Halifax Community College Foundation Inc. Gifts Of Stock Contribution Form
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A form for donating stock to the Halifax Community College Foundation for various funds and purposes.
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XAVIER HAP 2024 Personal Health History
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A comprehensive medical history form for students, to be completed by parents or guardians before submitting to a medical provider.
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Interview Form
PDF template
A document used to collect details about alleged harassment incidents within a school district.
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MC Hardware Request
PDF template
A form for requesting computer hardware for Montgomery College employees, with options for remote work and instructional needs.
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Settlement Agreement Harper Et Al. V. Massachusetts Department Of Transitional Assistance
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A settlement agreement addressing access to benefits for individuals with disabilities at the Massachusetts Department of Transitional Assistance
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HAZARD REPORT FORM
PDF template
A standardized form for documenting workplace safety hazards, observations, and recommended corrective actions.
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HAZARD REPORT FORM
PDF template
A document for employees to report workplace safety hazards and for management to investigate and resolve potential risks.
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Hazard Report Form
PDF template
A comprehensive form for identifying, assessing, and reporting workplace safety hazards with risk assessment matrix.
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HAZARD REPORT FORM
PDF template
A comprehensive form for documenting workplace safety hazards, potential risks, and immediate actions taken to mitigate dangers.
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Hiram College Enrollment Form
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A comprehensive benefits enrollment form for Hiram College employees covering medical, dental, vision, and supplemental insurance options.
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HEALTHCARE ADVOCATE TOOLS LINKS PHONE NUMBERS
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Comprehensive guide for AlaskaCare employees and retirees with contact information and resources for health insurance plans and provider networks.
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Family Household Income Statement
PDF template
Form for verifying household income and financial assistance for Child Care services through the Ohio Department of Job & Family Services.
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Mandatory Tuberculosis (TB) Risk Assessment Form
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A comprehensive medical form to assess tuberculosis risk factors and required testing for students, particularly those from high-risk regions or with specific exposure history.
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Role And Function Of The Joint Health Safety Environmental Committee Of The Mona Campus
PDF template
A comprehensive document outlining the establishment, role, and function of the Joint Health and Safety Environmental Committee at the University of the West Indies Mona Campus.
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Western Carolina University Base Camp Cullowhee Health And Medical Form
PDF template
A health screening form for participants in outdoor activities, collecting medical history and current health status details for safety purposes.
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Health And Temperament Agreement
PDF template
A legal agreement outlining owner responsibilities and liability waivers for dogs attending a dog daycare facility.
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SUNY State College Of Optometry Health Assessment
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Medical immunization and health screening form for SUNY State College of Optometry credentialing purposes.
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Health Assessment Form For Compliance With K.S.A. 72 5214
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A comprehensive health screening form for children entering school, requiring parental consent and medical provider certification.
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Software Solutions For The School Setting
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A software solution for tracking student and staff health information, designed to support schools during pandemic return-to-school protocols.
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Tips For Claim Submission
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Comprehensive guide for submitting healthcare and flexible spending account claims, detailing documentation requirements and eligible expenses.
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Eligibility And Enrollment Information For Employees
PDF template
A comprehensive form for employees to provide personal information and make flexible spending account elections.
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Health Examination Form (Form 003)
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Comprehensive health examination and immunization requirements form for nursing students entering a clinical program.
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Guam Travelers Health Declaration Form
PDF template
Health screening form for travelers entering Guam, tracking travel history, health symptoms, and potential exposure risks.
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HEALTH DECLARATION FORM
PDF template
A form for travelers to declare their COVID-19 health status and potential exposure prior to travel.
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Health Benefits Plan Enrollment For Retirees And Survivors
PDF template
Enrollment form for CalPERS retirees and survivors to manage health benefits coverage and dependent information.
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Student Health Services Health Evaluation Form
PDF template
Medical form used by students to document health status, current conditions, and activity clearance for university health services.
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Required NYS School Health Examination Form
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Comprehensive health assessment form for students in New York State, documenting medical history and physical examination details.
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CHILDCARE GENERAL HEALTH EXAMINATION FORM
PDF template
A health examination form for children enrolling in early education programs to document their medical status and health conditions.
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Student Health Fee Reimbursement Form
PDF template
Form for Florida A&M University law students to request reimbursement for health service fees
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HealthFlex Mandatory Premium And Coverage Waiver Form
PDF template
A form for employees to decline health insurance coverage and declare reasons for waiving enrollment in the HealthFlex plan.
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Health Form
PDF template
Medical health assessment form for participants in wilderness expeditions with Alaska Mountain Guides and Climbing School Inc.
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Girl Scouts Of West Central Florida Health Examination Form
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Comprehensive health form for documenting medical history and emergency contact information for Girl Scouts participants and volunteers.
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Emergency And Health Forms Checklist
PDF template
Comprehensive checklist of required health and emergency forms for new and returning students to complete before the school year
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Medical History Form
PDF template
Comprehensive medical history form for students collecting personal health information, medical conditions, and health maintenance details.
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Medical History Form
PDF template
Comprehensive medical history form capturing patient's health status, previous illnesses, and current medical conditions.
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Health History Physical Exam Form
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Confidential medical history form for Allied Health and Nursing students at Minnesota West Community and Technical College to document health status and medical background.
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Health History Form
PDF template
Comprehensive health form for students to provide medical history, insurance, and emergency contact information to the university's student health center.
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Student Athlete Health History Questionnaire
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Comprehensive medical history questionnaire for student-athletes at State University of New York at Potsdam, focusing on orthopedic and head injury history.
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Male Health History Questionnaire
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Comprehensive medical questionnaire for collecting a male patient's health history, current concerns, and personal details.
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Health Incident Report Form
PDF template
A form for documenting health and safety incidents involving nursing students and faculty, to be completed within 24 hours of an occurrence.
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Health Information Form
PDF template
Detailed medical history and personal health form for participants, collecting comprehensive health information and emergency contact details.
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Retiree Health Cancellation Form
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A form for retirees to cancel their health coverage and dependent coverage through Blue Cross Blue Shield.
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School Health Inspection Form
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Official form for documenting health and safety inspections of school facilities in New Hampshire, ensuring compliance with state education standards.
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School Health Inspection Form
PDF template
Official form for documenting health and safety inspections of school facilities by local health officials in New Hampshire.
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Maryland State Department Of Education Health Inventory
PDF template
A comprehensive health documentation form for children enrolling in Maryland child care facilities, requiring physical examination, immunization records, and blood-lead testing information.
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HEALTH INVENTORY FORM
PDF template
A comprehensive medical history form for collecting student health information, including past diseases, treatments, and current medical status.
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Authorization For Use Or Disclosure Of Protected Health Information
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A confidential form authorizing the disclosure of protected health information by The Episcopal Church Medical Trust
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HEALTHPHYSICAL EXAMINATION FORM
PDF template
Medical examination form for students enrolling in various healthcare and child care educational programs to assess physical fitness and health status.
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Lindgren Child Care Center Health Procedures
PDF template
Comprehensive guidelines for handwashing and managing child health procedures in a child care center, focusing on preventing illness spread.
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HEALTH PROFESSIONS STUDENT HEALTH FORM
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Medical documentation form for students in nursing, pharmacy, physician assistant, and dietetic internship programs, requiring immunization history and verification.
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ETA FORM 653 Job Corps Health Questionnaire
PDF template
A health assessment form for Job Corps applicants to provide medical information and authorize basic healthcare services
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Health Risk Assessment Form
PDF template
A comprehensive form that evaluates an individual's physical health, personal safety, fitness, nutrition, work environment, and social-emotional well-being.
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Health And Safety Student Waiver Form Part A
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COVID-19 safety waiver for students participating in boot camp activities at the Bahamas Technical and Vocational Institute.
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Health Savings Account (HSA) Contribution Form
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A form for depositing funds into a Health Savings Account with instructions for contribution types and participant authorization.
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Portland Community College HSA Payroll Contribution Form
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Form for employees to set up pre-tax payroll contributions to a Health Savings Account (HSA) through Optum.
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Physical Examination Form
PDF template
A comprehensive medical examination form required for admission to health science programs at Laredo College.
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Health Screening Benefit Claim Form
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Claim form for requesting reimbursement of health screening benefits under critical illness or supplemental health plans.
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MCPS Form SRS 6 Student Record Card 6
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A comprehensive health form for students entering Maryland public schools, requiring medical examination and immunization documentation.
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Meningitis And Hepatitis B Immunization Health History Form
PDF template
Comprehensive form detailing immunization requirements for students, including MMR, Varicella, and Tuberculosis skin test documentation guidelines.
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School Health Services Health Survey Form
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A comprehensive health information form for students entering school, collecting medical history, contact information, and health service needs.
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Vital Strategies Healthy Food Policy Fellowship Application Form
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Application form for a fellowship program focused on contributing to healthier food environments in selected countries.
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DCH 1315 Health Risk Assessment
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A confidential form for collecting personal health information to help individuals improve their health and healthcare coverage through the Healthy Michigan Plan.
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STUDENT RECORD CARD SR 6 (Local)
PDF template
A mandatory health form for students entering Maryland public schools, documenting physical examinations and immunization requirements.
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Medical Form
PDF template
Medical history and immunization form for students, requiring detailed health information and parental consent.
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Medical Form
PDF template
Comprehensive medical history and immunization form for students, requiring detailed health information to be completed by parents/guardians and physicians.
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Faculty Staff Payroll Deduction Form
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A form for faculty and staff to authorize recurring payroll deductions to support the Herd Rises Campaign scholarship fund.
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Disability Claim Form
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A comprehensive claim form for submitting disability insurance claims with Unum Group subsidiaries.
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Statement Of Kurt DelBene On VA.Gov
PDF template
Congressional testimony about the Department of Veterans Affairs' VA.gov website, its usage, services, and digital modernization efforts.
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Patient Intake Form
PDF template
Comprehensive medical questionnaire collecting patient personal, insurance, and health history information for medical providers.
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Privacy Complaint Form
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A form for patients to submit written complaints regarding privacy and confidentiality of protected health information.
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MDwise Healthy Indiana Plan (HIP) Employer And Other Third Party Contribution Form
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A form for employers and third parties to coordinate payment of Healthy Indiana Plan Member POWER Account Contributions.
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Time Off Request Form
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A form for employees to request various types of time off including vacation, sick pay, bereavement, and medical/dental leave
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Hiring Official Checklist
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Comprehensive guide for hiring managers outlining steps to successfully onboard a new employee from interview through first 90 days.
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Medical History Form
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Comprehensive medical form for capturing patient health history, symptoms, and medical conditions across various body systems.
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Harvard Outing Club Medical Form
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A comprehensive medical form for Outing Club members to provide emergency medical information and disclose health conditions that might impact trip participation.
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Holiday Time Off Request Form
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Internal communication about holiday time off requests and current MVP recognition counts for employees.
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Homelessness Prevention Benefit Application For Assistance
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A benefit program to assist low-income households in Leeds and Grenville with housing stability and prevention of homelessness.
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Homelessness Prevention Benefit Application For Assistance
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A benefit program assisting low-income households in Leeds and Grenville to obtain and retain housing, supporting those at risk of homelessness.
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Hospice RevocationDischarge Form
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A form for documenting hospice patient discharge or service revocation under Medicaid guidelines
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Exemption Certificate
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A form for federal employees to certify tax-exempt purchases made on behalf of their government agency.
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Hourly Time Sheet Form
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Household Report Form
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Official form for reporting household information to determine public assistance benefits in Minnesota.
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How To Submit A Claim For Critical Illness, Accident And Hospital Indemnity Insurance
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Comprehensive guide for filing insurance claims for critical illness, accident, and hospital indemnity coverage with The Hartford.
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Short Term Disability Claim Form
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Instructions for filing a short-term disability insurance claim through Mutual of Omaha, detailing submission methods and required sections.
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Employee Travel Authorization Settlement Form
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Comprehensive guide for employees to complete a travel authorization and expense settlement document for organizational travel.
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Stationary Order Form
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Step-by-step guide for employees to order business cards, stationary, and name badges through the SLCC employee portal.
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UCR Retiree Association Membership Information
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Comprehensive guide for University of California, Riverside retirees outlining membership benefits, access, and how to join the retiree association.
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Accident Investigation Report
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A comprehensive form for documenting workplace accidents, including details of injury, witness statements, and reporting procedures.
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Medical History Form
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Comprehensive form for documenting patient medical history, conditions, and potential health issues
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Declaration Of Payroll Deduction
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Form for employees to authorize payroll deductions for retirement accounts, contributions, and miscellaneous purposes.
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EXIT INTERVIEW
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A comprehensive interview form for employees leaving an organization, capturing insights about their work experience and reasons for departure.
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Safety Inspections Policy
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Policy detailing monthly safety inspection requirements for all CCLA sites and facilities by safety administrators or Health & Safety Manager.
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HR 8 Leave Request Form
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A form for employees to request and allocate leave hours across different leave types for a specific pay period.
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Health Reimbursement Account (HRA) Claim Form
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A form for employees to submit healthcare expense reimbursement claims through their Health Reimbursement Account (HRA)
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Change Of Address Form
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Document for employees to update their address for health benefits and pension purposes
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Employee Evaluation Form
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A comprehensive form for assessing employee performance, strengths, goals, and development needs.
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EmployeeS InjuryIllness Report Form
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A comprehensive form for documenting workplace injuries or illnesses at the Fashion Institute of Technology.
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Employee Time Off Request
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A form for employees to request time off, to be submitted at least one week prior to the first day of leave.
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FMLA LEAVE REQUEST FORM
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A comprehensive form for employees to request leave under the Family and Medical Leave Act (FMLA) for various qualifying reasons.
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CSEA Leave Request Form
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A form for employees to request various types of leave from work, including sick, vacation, personal, and other leave types.
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MSC Leave Request Form
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A comprehensive form for employees to request various types of leave from their employer, covering sick, vacation, personal, and specialized leave types.
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Supplemental Insurance Cancellation Form
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A form for employees to cancel pre-tax and post-tax supplemental insurance deductions with specified effective date.
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Sample Employee Resignation Form
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A comprehensive guide for managing employee resignation or termination processes, covering administrative, legal, and IT-related tasks.
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Open Enrollment And HR Benefits Communication
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Document covering open enrollment period, CARES Act unemployment information, and employee performance evaluation process for 2020.
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HSA Payroll Deduction Form
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Employee form for setting up pre-tax payroll deductions to a Health Savings Account (HSA) through Grand Rapids Community College.
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Health Research Institute Membership Form
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Form for faculty members to apply for membership in the Health Research Institute, requiring personal details and departmental approval.
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SUNY GENESEO LEAVE REQUEST FORM
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A comprehensive form for employees to request various types of leave, including Family Medical Leave, Paid Family Leave, and Parental Leave.
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SUNY Geneseo Leave Request Form
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A comprehensive form for employees to request various types of leave, including FMLA, NYS Paid Family Leave, and NYS Paid Parental Leave
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Changing Your Name AndOr Address
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Comprehensive guide detailing the forms and departments employees must notify when changing personal information such as name or address.
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Performance Review Form Hourly Employees
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Performance Assessment Form For Classified Exempt Employees
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Wellness Program Reimbursement Form
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Form for full-time employees to request up to $50 annual reimbursement for health and fitness program costs for themselves and dependents.
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Health Savings Account Contribution Form
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Form for individuals to make personal contributions to a Health Savings Account (HSA)
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Employee HSA Payroll Deduction Form
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Form for employees to authorize payroll deductions for Health Savings Account contributions with contribution limit details.
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HSA Contribution Form
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A form for employees to adjust their Health Savings Account contributions through payroll deductions, specifying contribution amounts and frequency.
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Health Savings Account 2023 Payroll Deduction Contribution Form
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Form for employees to start, stop, or change Health Savings Account (HSA) contributions through payroll deductions.
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Health Savings Account 2024 Payroll Deduction Contribution Form
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Form for employees to start, stop, or change Health Savings Account (HSA) contributions through payroll deductions for the 2024 plan year.
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HEALTH SAVINGS ACCOUNT Voluntary Contribution Designation
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University of Arizona form for employees to voluntarily designate contributions to their Health Savings Account
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Health Savings Account Contribution Form
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Form for making contributions to a Health Savings Account with Bank of America, allowing deposits for current or previous tax year.
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HSA Contribution Form
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A form used to make contributions to a Health Savings Account, including options for current year, prior year, and catch-up contributions.
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Health Savings Account (HSA) Contribution Form
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A form for employees to enroll in and specify Health Savings Account (HSA) contributions, including eligibility requirements and tax considerations.
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Health Savings Account (HSA) Contribution Form
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A form for individuals to make contributions to their Health Savings Account through various deposit methods.
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Health Savings Account (HSA) Contribution Form
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A form for employees to authorize salary reduction for Health Savings Account contributions under a High Deductible Health Plan
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Health Savings Account Employer Contribution Form
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A form for employers to make contributions to employee Health Savings Accounts with specific contribution details and authorization.
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HEALTH SAVINGS ACCOUNT EMPLOYER CONTRIBUTION FORM
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A form for employers to make contributions to employee Health Savings Accounts (HSAs) with details for initial and subsequent contributions.
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HSA Enrollment Form
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A form for employees to enroll in a Health Savings Account (HSA) with employer contribution and payroll deduction options.
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Health Savings Account Payroll Deduction 2021
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Form for employees to authorize health savings account contributions through payroll deduction for qualified high deductible medical plans.
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Health Savings Account (HSA) Payroll Deduction Form
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A form for employees to establish, change, or stop payroll deductions for their health savings account (HSA)
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HSA Payroll Deduction Authorization Form
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Form for employees to authorize payroll deductions for health savings account contributions through the City of Wisconsin Rapids.
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BlueFund HSA Payroll Deduction Form
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A form for employees to set up payroll deductions for a Health Savings Account (HSA) with contribution guidelines and instructions.
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Disciplinary Action Form
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A formal document used to record and track employee performance issues, misconduct, and potential disciplinary actions at the University Health Science Center.
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Health Contact Form
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A bilingual form for tracking medical, dental, and health visits for foster children in Sonoma County
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HEALTH CONCERN SAFETY HAZARD CHEMICAL SPILL REPORT FORM
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A form for reporting health concerns, safety hazards, or chemical spills with details and recommended actions.
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Health And Safety Form General Risk Assessment (Dynamic)
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A comprehensive document for assessing workplace health and safety risks across multiple potential hazard categories.
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Health And Safety Form Incident Investigation Form
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A confidential form used to document and investigate workplace incidents and accidents for North Lanarkshire Council.
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INCIDENT REPORTING FORM
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Official form for documenting work-related injuries, illnesses, or near-miss events in a workplace setting.
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Manual Handling Risk Assessment Form
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A comprehensive form for assessing potential risks in manual handling tasks for employees and students.
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Physical Examination Form
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A comprehensive medical physical examination form for nursing students at Mennonite College of Nursing, Illinois State University.
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Health Standards Post Event Assessment Form
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A comprehensive form for assessing facility conditions and readiness after an emergency event, specifically for healthcare facilities and nursing homes.
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Discretionary Residency Benefit Application Form
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Financial assistance program for Ontario Works and ODSP recipients who are homeless, at risk of homelessness, or moving to more affordable housing.
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BARBADOS LOGISTICS INFORMATION
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Provides travel and entry information for participants attending health services seminars in Barbados in October 2012.
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Drug Alcohol Education And Testing Program
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Policy outlining drug and alcohol testing requirements for student-athletes, focusing on health, safety, and athletic integrity.
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HUDESGSTEHP ES PREV DISCHARGE
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A form used to collect universal data elements and income/benefits information when a client exits a homeless shelter or prevention program.
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AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS (ACH CREDITS)
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A form for employees to authorize automatic electronic deposits of funds into their bank accounts by the College.
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Huron Valley Percussion Physical Examination Form
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Comprehensive health screening form for student musicians detailing medical history and physician examination findings.
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Healthcare Worker Bonus Employee Inquiry Form Instructions
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Form for healthcare workers to apply for bonus eligibility by providing employment and qualification details.
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Hy Flex Attendance Certification Form
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Form for documenting in-classroom attendance for hy-flex courses to maintain VA education benefits eligibility.
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Disciplinary Action Form
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A standard form for documenting workplace misconduct and corresponding disciplinary measures for employees.
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Form 5310 (Rev. May 2023)
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IRS form for requesting a determination letter on the qualified status of a pension, profit-sharing, or deferred compensation plan upon termination.
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Record Of Employment
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A form for documenting employment status for unemployment insurance purposes in New York State.
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Record Of Employment
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A form for documenting employment details for unemployment insurance claims in New York State.
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Employee Classification And Hiring Processes Audit Report 19 02
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An internal audit examining the Department's human resources hiring processes, job classification reviews, and associated procedural effectiveness.
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Retirement Plan Consulting Agreement (RPCA)
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A non-discretionary retirement plan consulting services agreement between a client and Coordinated Capital Securities, Inc.
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National Pension Fund Plan C
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A pension fund document listing trustees, executive directors, fund counsel, and consultants for the International Alliance of Theatrical Stage Employees (IATSE) pension plan.
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Pension Plan Document
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Comprehensive document outlining the structure, benefits, and operational details of a pension plan for employees.
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HKASME Sales Order Form IB Paper (November)
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Order form for purchasing International Baccalaureate (IB) past exam papers and marking schemes for various subjects and years.
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Employee Emergency Contact Form
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A form for collecting employee personal and emergency contact details for workplace safety and emergency response purposes.
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EMPLOYEE LEAVE REQUEST FORM
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A form for employees to request time off, specifying leave type, dates, and obtaining supervisor approval.
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457 DEFERRED COMPENSATION PLANS CONTRIBUTION FORM
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Form for participants to change contribution amounts to their 457 deferred compensation plan account with ICMA-RC.
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Direct RolloverTransfer To ICMA RC Packet
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Instructions for transferring retirement assets to or between ICMA-RC retirement accounts and plans.
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MEDICAL HISTORY FORM TEMPLATE
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A comprehensive form for collecting patient medical information including medications, surgical procedures, illnesses, and vaccination history.
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PAR Contribution Form
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A form for authorizing monthly financial contributions to Immanuel Christian Reformed Church through automatic bank withdrawals.
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Simple Printable Expense Report Form
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A form for employees to document and submit work-related expenses for reimbursement.
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ICSVEBA 2021 Back To School E Kit Guide
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Comprehensive benefits enrollment guide for San Pasqual Valley Unified School District employees for the 2021-2022 school year
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Federal Employees Health Benefits (FEHB) Premium Conversion Election Form
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Form for federal employees to elect or waive pre-tax treatment of health insurance premium contributions.
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Preparticipation Physical Evaluation Medical Eligibility Form
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Medical form for evaluating student-athlete's health and sports participation eligibility, including medical history and emergency contact information.
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Fiscal Sponsorship Donor Contribution Form
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A form for donors to contribute financially to a specific film or media project through fiscal sponsorship.
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Contribution Form
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A form for making initial or additional contributions to a donor advised, designated, field of interest, or unrestricted fund with minimum contribution requirements.
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Saint Ignatius High School FreshmanTransfer PHYSICAL EXAMINATION FORM
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Required medical examination form for freshmen and transfer students at Saint Ignatius High School, including health screening and medical history details.
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Employee SystemsAccess Checklist Form
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A form for tracking and managing system access and resources for new or transitioning employees in an educational or administrative setting.
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Procedure III.3001.G.A, Employee Travel
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Comprehensive policy governing official college travel, including expenditure guidelines, approval processes, and reimbursement procedures for employees.
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IncidentHazard Report Program
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A comprehensive program for employees to report workplace hazards and potential safety risks within county departments.
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T. Gerding Construction Company Injury Illness Prevention Program
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Comprehensive safety and health management manual for construction company covering administrative procedures, occupational health, and safety protocols.
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Proof Of School Dental Examination Form
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A mandatory dental examination form for students in kindergarten, 2nd, 6th, and 9th grades in Illinois, documenting oral health status.
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Proof Of School Dental Examination Form
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A comprehensive dental health form for documenting a student's oral health status and treatment needs for school enrollment.
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Required Certificate Of Immunization
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A comprehensive form documenting required immunizations for students, including vaccination history and personal information.
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Immunization Record Form
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A comprehensive form for documenting student immunization history and requirements for university enrollment.
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Immunization Request For ExemptionWaiver Form
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A form allowing students to request medical or personal exemptions from required immunizations for university admission.
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South Dakota Immunization Order Form
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Order form for immunization-related supplies, forms, and resources for healthcare providers in South Dakota.
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Authorization For Release Of MedicalHealth Information
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Missouri Department of Social Services form authorizing the release of an individual's medical and health information to specified parties.
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Parental Consent Form
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Consent form for students to participate in computerized concussion baseline testing program for athletic participation.
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Donation Procurement Form
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A form for collecting and documenting item donations for a non-profit organization.
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Inactive Employee Change Of Address Form
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Form for updating mailing address for inactive employees at George Washington University for W2 tax purposes.
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Inactive Employee Change Of Address Form
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Form for inactive employees to update their mailing address for W2 tax documents at George Washington University.
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Incident And Hazard Report Physical And Psychosocial
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A comprehensive form for documenting workplace incidents, hazards, injuries, and required corrective actions.
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Workplace Violence Incident Investigation Form
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A comprehensive form for documenting and investigating workplace violence incidents, including details about the event, parties involved, and preventative recommendations.
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INCIDENT INJURY HAZARD REPORTING PROCEDURE
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A comprehensive procedure for reporting, investigating, and preventing workplace incidents, injuries, and hazards to ensure health and safety.
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Incident Report Form
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A comprehensive form for reporting workplace or campus-related incidents, injuries, and potential safety issues.
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Wildlife Incident Report Form
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A comprehensive form for documenting and reporting wildlife health incidents, including species details, environmental conditions, and collected specimens.
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Incident Report
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A comprehensive form for documenting workplace incidents, accidents, and potential injuries at Upper Merion Township.
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Employee, Volunteer Youth AccidentIncident Report Form
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A comprehensive form for documenting accidents, incidents, and injuries involving employees, volunteers, and youth participants at the University of Kentucky Cooperative Extension Service.
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Employee, Volunteer Youth AccidentIncident Report Form
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A comprehensive form for documenting accidents, incidents, and injuries involving employees, volunteers, and youth participants at the University of Kentucky Cooperative Extension Service.
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How To File An Incident Report
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Comprehensive guide for reporting workplace, student, and visitor incidents at Clark College, detailing the proper procedures for documenting accidents and near misses.
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CANTON PUBLIC SCHOOLS INCIDENT REPORTS FOR STUDENTS AND STAFF
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Guidelines for documenting and reporting accidents, injuries, and significant health incidents involving students and staff at Canton Public Schools.
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Income Tax Withholding Form
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Form for electing tax withholding options for pension payments from Imperial County Employees' Retirement System
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Income Tax Withholding Instructions
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Instructions for employees on state and federal tax withholding procedures and submission requirements for Occidental Petroleum Corporation.
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How To Use Your New Caremark Prescription Drug Program
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Guide explaining new prescription drug coverage details for county employees through Caremark beginning January 1, 2011.
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Molloy University EmployeeIndependent Contractor Checklist
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A form used to determine whether an individual should be classified as an employee or independent contractor at Molloy University.
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Request For Proposal For Independent Pension Administration System Assessment
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Solicitation for a qualified contractor to provide project oversight for the Teachers' Retirement System's new pension administration system called Gemini.
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Section 900 INDEX
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Comprehensive index of employee policies and workplace guidelines for a county government organization.
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Individual Membership Form
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A confidential membership form for individuals interested in joining the Narcolepsy Network organization with various membership levels and donation options.
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Individual Reimbursement Form
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A comprehensive form for processing individual reimbursements and verifying employment and citizenship status for the Texas A&M University System.
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Influenza Sample Submission Form
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A detailed form for submitting influenza test samples to the South Dakota Public Health Laboratory with comprehensive patient and specimen information.
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Initial Interview Form
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A comprehensive form for veterans and their family members to collect information needed to apply for veterans' benefits.
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Medical History Form
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Comprehensive medical history questionnaire used by Egea Medical Weight Loss Center to collect patient health information and background.
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Louisiana State Employees Retirement System Purchase Of Service Credit For Military Service
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Proposed amendments to retirement system rules regarding military service credit purchase, aligning with federal and state regulations.
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Risk Assessment For Hazardous Agents And Animal Contact
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A comprehensive form for evaluating occupational health risks associated with hazardous agents and animal contact in a research environment.
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Injury And Illness Prevention Program
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Comprehensive safety policy and procedures manual for preventing workplace injuries and addressing health risks in a school district setting.
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INJURY AND ILLNESS PREVENTION PROGRAM
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Comprehensive safety and health program detailing hazard prevention, training, and workplace safety protocols for school district employees.
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IncidentInjuryHazard Notification Form
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A comprehensive form for reporting workplace incidents, injuries, illnesses, hazards, or near misses within a university setting.
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Injury Incident Report Workers Compensation
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A form documenting workplace injury incidents with no medical treatment required, used for tracking workplace safety and potential compensation claims.
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PUBLIC POOL AND SPA INJURY INCIDENT REPORT FORM
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A standardized form for reporting injuries, drownings, or near-drownings at public pools and spas to local health districts.
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UVU Injury Accident Report Form
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Comprehensive form for documenting accidents and injuries occurring at Utah Valley University or during university-sponsored activities.
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Injury And Third Party Liability Form
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A form for documenting injuries potentially involving third-party liability for the Southern California Pipe Trades Health & Welfare Fund.
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IN KIND CONTRIBUTION FORM
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A form for documenting in-kind contributions including time, resources, and media coverage for a community prevention coalition.
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Morris County Trails Construction Grant Program Volunteer In Kind Contribution Form
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A form for documenting volunteer services and contributions for a trails construction grant program in Morris County, New Jersey.
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IRA Innovations Disclaimer And Indemnity Agreement
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A legal document outlining terms and responsibilities for investments made through a self-directed retirement account with IRA Innovations
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Unsecured Promissory Note Disclaimer And Indemnity Agreement
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A legal document outlining responsibilities and understanding between an IRA account holder and their account administrator regarding investment activities.
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Thrift Savings Plan In Service Withdrawals
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A comprehensive guide explaining in-service withdrawal options for federal civilian employees and uniformed services members in the Thrift Savings Plan.
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LABORATORY SAFETY INSPECTION FORM
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Comprehensive safety inspection form for evaluating laboratory safety protocols, equipment, and compliance with safety standards.
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Lab Safety Inspection Form
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Comprehensive safety inspection form for evaluating laboratory safety conditions and compliance with environmental health standards.
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Individual Request For Approval For Out Of State Travel
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A form for university employees to request approval and document details for out-of-state travel
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INSTRUCTIONS FOR MEDICAL REQUIREMENTS FOR CONDITIONALLY APPOINTED APPLICANTS
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Detailed guidelines for completing medical forms for conditionally appointed VMI applicants through the Medicat Portal.
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Insurance Form For Residence Hall Students
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Form for collecting student health insurance information for residential students at Monroe Community College.
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EMPLOYEE WAIVER OF HEALTH INSURANCE FORM
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Form for employees to waive group health insurance coverage due to alternative coverage.
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Partnership Contribution Form
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A form for documenting partnership contributions to InsurPac, detailing how contributions are attributed among partners.
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DELL COMPUTER REQUEST FORM
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Official form for requesting Dell computer products for university departments, with specific instructions for processing and approval.
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Patient Intake Form
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Comprehensive medical intake form for new chiropractic patients to document personal information, health history, and current medical conditions.
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IntakeReferral Form
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A form for reporting workplace incidents, complaints, or potential misconduct within a Tennessee state agency.
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Interim Evaluation Form
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A form for documenting an employee's interim performance review, highlighting areas of achievement and improvement.
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Internal Employee Transfer Request Form
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A form for employees to request an internal transfer to an open position within the organization.
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Internal Mobility Applicant Interview Form
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A detailed form for collecting employment history, qualifications, and performance information for internal job mobility candidates.
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Internal Transfer Request Form
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A formal document for employees seeking to transfer to another position within an organization, outlining required procedures and qualifications.
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International Claim Form
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A comprehensive form for submitting international healthcare insurance claims with patient and coverage details.
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International Student Insurance Refund Request
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A form for international students studying remotely due to COVID-19 to request a health insurance refund for the Spring 2023 semester.
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Entry Medical Examination United Nations And Specialized Agencies
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Medical examination form for employment candidates seeking positions with United Nations and specialized agencies, requiring comprehensive health disclosure and authorization for medical record review.
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Employee Direct Deposit Authorization Form
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A form for employees to authorize direct deposit of their paychecks into one or two bank accounts by providing account details and signature.
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Retirement Plan Consulting Agreement
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An agreement for non-discretionary retirement plan consulting services provided by Coordinated Capital Securities, Inc. to a client.
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Application Form For Invalidity Pension
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Official government form for applying for Invalidity Pension in Ireland, with detailed instructions for completion.
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Investigation Checklist Form
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A structured guide for conducting neutral and confidential workplace investigations into employee complaints or harassment concerns.
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PA 529 Investment Plan Contribution Form
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Form for making additional contributions to a Pennsylvania 529 Investment Plan account by check or rollover
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WEA Member Benefits IRA Contribution
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A form for making contributions to various types of Individual Retirement Accounts (Traditional, Roth, and SEP IRAs) with eligibility requirements and contribution details.
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Conversion Of A Traditional IRA To Roth IRA
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Comprehensive guide explaining the process, tax implications, and key considerations for converting a traditional IRA to a Roth IRA.
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IRAIRRARoth IRASEPSRA One Time Distribution Form
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A form used to request a withdrawal from various types of retirement accounts offered by Merrill Lynch, including IRAs, Roth IRAs, and SEP accounts.
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IRA State Income Tax Withholding Election
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A form for designating state income tax withholding preferences for IRA distributions from Ally Bank.
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INDIVIDUAL RETIREMENT ACCOUNT (IRA) TRANSFER REQUEST FORM
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A form for transferring retirement account assets from an existing IRA or employer-sponsored retirement plan to a Green Century IRA.
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Incident Report Form
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A standardized form for documenting workplace incidents, injuries, or damages involving employees or volunteers.
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Income Related Monthly Adjustment Amount (IRMAA) Reimbursement Form
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Form for New York City retirees to request reimbursement for Medicare Part B income-related monthly adjustment amount premiums.
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Medicare Part B Income Related Monthly Adjustment Amount (IRMAA) Reimbursement Form
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Form for NYC employees to request reimbursement for Medicare Part B premiums exceeding standard monthly amounts.
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Notice Regarding Federal And State Income Tax Withholding Requirements On Retirement Income
PDF template
Instructions for federal and California state tax withholding for retirement income from Los Angeles County Employees Retirement Association.
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Impairment Related Work Expense Request
PDF template
Form for reporting work-related expenses for Social Security disability beneficiaries to potentially offset income calculations.
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Information Technology Project Request Form
PDF template
A comprehensive form for submitting and evaluating technology project proposals within an organization
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IT Addendum To ContractorS Contract Form
PDF template
An addendum modifying standard contract terms for IT services between a contractor and the Virginia Community College System (VCCS)
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CDW Customer Service Order Form
PDF template
Agreement between Tulsa County and CDW Government, LLC for Mimecast M2A and LCS-Gold annual subscriptions
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3.3 Incident Investigation Form
PDF template
A comprehensive form for documenting and investigating workplace incidents, accidents, and near misses, designed to capture detailed information about safety events.
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GOLD COAST TRANSIT TRAVEL OTHER EXPENSE REPORT FORM
PDF template
A form for employees to report and request reimbursement for travel and miscellaneous expenses.
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GOLD COAST TRANSIT TRAVEL OTHER EXPENSE REPORT FORM
PDF template
A form for documenting employee travel expenses and reimbursement claims for Gold Coast Transit.
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Invoice For Investment Consulting Services
PDF template
Invoice from Investment Solutions for investment consulting services provided to the City of Cartersville, Georgia Retirement Board
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I.T Maintenance Request Form
PDF template
A form used to document and track IT equipment maintenance requests within an organization.
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ITP 3 Technology Governance And Procurement Review
PDF template
Administrative procedure defining the technology governance process and requirements for technology procurement review at Marshall University.
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Information Technology Professional Services Agreement
PDF template
A service agreement between Cornell University and a technology consultant for professional IT services and deliverables.
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SIUE ITS Network Infrastructure Management Service Requisition Form
PDF template
A form for requesting network and infrastructure services at Southern Illinois University Edwardsville (SIUE)
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Information Technology Services Purchase Requisition Form
PDF template
Guidelines for staff to request and purchase IT equipment through the Information Technology Services department's requisition process.
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Australian Expatriate Superannuation Fund Pension Application Form
PDF template
Application form for Australian expatriate superannuation fund pension, requiring personal details and tax information.
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Payroll Deduction Authorization Form
PDF template
Form for employees to authorize ongoing or one-time payroll deductions to the Wesleyan Fund
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Medical Release Form
PDF template
A form for documenting participant medical history, conditions, medications, and emergency contact information.
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Dana Farber Cancer Institute And The Jimmy Fund Contribution Form
PDF template
A form for making charitable donations to Dana-Farber Cancer Institute and the Jimmy Fund, including one-time and monthly giving options.
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Job Related Training And Education Employee Request Form
PDF template
Form for employees to request tuition reimbursement and time off for job-related educational programs at UTHealth.
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My Enrollment Form
PDF template
Instructions for enrolling in a retirement plan with John Hancock, including investment options and account consolidation guidance.
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Medical Alert Form
PDF template
Medical information form for students using Johnson Bus Company transportation services in Menomonee Falls School District.
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JOINT PURCHASE FORM
PDF template
A form for multiple buildings or departments to collaborate on a shared purchase by documenting contributions and approvals.
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University SystemEmployee Intellectual Property Joint Participation MUSP 407
PDF template
A form for university employees to seek approval for intellectual property arrangements involving business entities and potential conflicts of interest.
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Joyner Library Contribution Form
PDF template
A contribution form for making financial donations to support Joyner Library at East Carolina University through various funding options.
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Authorization, Agreement, And Certification Of Training
PDF template
A comprehensive document for recording employee training details, course information, and agency-specific training data.
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Jamestown Injury And Illness Prevention Program
PDF template
Comprehensive safety program outlining injury prevention, hazard identification, and employee health protocols for Jamestown School District.
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JAMESTOWN INJURY AND ILLNESS PREVENTION PROGRAM
PDF template
Comprehensive safety and health program outlining hazard prevention, employee training, and communication protocols for Jamestown School District.
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WHS Forms Register
PDF template
Comprehensive register of workplace health and safety documentation with revision details and version tracking.
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Authorship Contribution Form
PDF template
A form documenting author contributions for manuscript submission to medical journal publications.
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HR Change Of Address Form
PDF template
A form for employees to update their personal contact information and notify benefits vendors of address changes.
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Transitions
PDF template
Monthly update document from Massachusetts Department of Transitional Assistance covering case transfer functionality, MBTA fare changes, and participation form guidelines.
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Physical Examination Form
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Required medical form for participants in Junior Hilltoppers Sports Clubs, documenting health status and emergency contact information.
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Jury DutyPre Trial Attendance Form
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Form for documenting an employee's attendance and time spent for jury duty or pre-trial proceedings.
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Medical Form
PDF template
A comprehensive medical history form for applicants to the JVC Northwest program, to be completed by a healthcare professional.
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KPERS 15B Direct Deposit Agreement
PDF template
Form for setting up direct deposit of retirement benefits with Kansas Public Employees Retirement System
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Designation Of Beneficiary For Life Insurance
PDF template
Form for Kansas Board of Regents members to designate life insurance beneficiaries for KPERS group life insurance benefits.
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DESIGNATION OF BENEFICIARY FOR LIFE INSURANCE KANSAS BOARD OF REGENTS MEMBERS
PDF template
Official form for Kansas Board of Regents members to designate life insurance beneficiaries for KPERS insurance benefits.
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Peralta Community College District Reimbursement Form
PDF template
Form for Peralta Community College District employees and retirees to claim medical expense reimbursements based on specific eligibility criteria.
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COVID 19 Leave Request Form
PDF template
Form for Kansas Department of Transportation employees to request leave related to COVID-19 testing and isolation
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KeyAccess Card Request Form
PDF template
Form for requesting keys and access cards for college employees, outlining access and usage requirements.
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Key Electronic Access Request Form
PDF template
Form for requesting building, room, and electronic access for employees at an organization, including key and FOB/PROX card requests.
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KEY AUTHORIZATION FORM FOR FAU JUPITER CAMPUS KEY(S)
PDF template
A form for requesting and tracking key issuance to employees at Florida Atlantic University's Jupiter Campus, detailing key distribution and return procedures.
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KEY (ACCESS) REQUISITION
PDF template
Form used to request new keys or access changes for employees at an educational institution
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Fertility Assessment Form
PDF template
A detailed medical form for couples assessing fertility challenges and medical history related to reproductive health.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for collecting new patient personal, contact, and health provider information
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Consent For Administration Of Health Treatment AndOr Medication At School
PDF template
A form for parents and healthcare providers to authorize medical treatments and medication administration during school hours.
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Aflac Cancer Wellness Claim Form
PDF template
Document providing guidance on filing wellness claims with Aflac insurance and information about Primary Care Provider (PCP) selection.
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Kindergarten Oral Health Assessment Form
PDF template
California mandated form for documenting kindergarten students' dental health assessment as required by state education law.
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My Benefits Manager Provider Portal Guide
PDF template
A comprehensive guide for healthcare providers to navigate the My Benefits Manager portal for claims, eligibility, and authorization management.
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KPERS Retirement Application
PDF template
Comprehensive guide and application for retirement benefits through the Kansas Public Employees Retirement System (KPERS)
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2025 Value Added Benefits
PDF template
Comprehensive benefits guide for pregnant and new mothers, offering rewards, support programs, and additional healthcare services.
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KSUF 1 Contribution Transmittal Form
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A form used for transmitting and documenting financial contributions to the Kansas State University Foundation, with specific instructions for submission.
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KUDOS Nomination Form
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A form for nominating employees in the Office of Human Resources for outstanding performance in specific award categories.
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Campus Kudos Nomination Form
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A form for recognizing and nominating UNM-Gallup employees who demonstrate exceptional service and positive behaviors.
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PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
A comprehensive health screening form for students entering Kentucky public schools, documenting medical history and physical examination results.
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PREVENTATIVE HEALTH CARE EXAMINATION FORM
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Required health examination form for Kentucky public school students entering school or sixth grade, documenting medical history and physical screening results.
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Benefit Application Form For Ontario Works
PDF template
A comprehensive application form for accessing various social assistance benefits and support services in Ontario, specifically for Gull Bay First Nation.
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Form L180b Special Power Of Attorney
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A form for Sonoma County Employees' Retirement Association members to appoint an Attorney-In-Fact to handle retirement-related matters.
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CAMERON UNIVERSITY LEAVE REQUEST FORM
PDF template
A form for employees to request various types of leave including vacation, sick, or special leave at Cameron University.
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Laboratory Contact Information And Emergency Procedures
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A document detailing emergency contact information and procedures for laboratory settings, including emergency contact details and reporting protocols.
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Emergency Procedures And Contact Information
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A document outlining emergency contact details and procedures for laboratory safety and emergency response.
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LABORATORY SAFETY CHECKLIST (FORM 3010)
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A comprehensive safety checklist designed to ensure awareness and compliance with laboratory safety policies and procedures for employees and visitors.
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Lab Biosafety Self Audit Form
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A comprehensive form for documenting biosafety practices and microbiological materials used in a research laboratory setting.
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Application For Pension
PDF template
Comprehensive pension application package for laborers seeking to start their pension benefit, including forms and instructions for benefit election.
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Lab Safety Checklist
PDF template
A comprehensive safety inspection form for evaluating laboratory safety conditions and compliance with workplace safety standards.
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My Medical Info
PDF template
A comprehensive medical information form designed to provide critical health details for emergency personnel in case of medical emergencies.
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Health Declaration Form For Applicants
PDF template
A health declaration form for international students applying to study in Malaysia, requiring disclosure of medical conditions and agreeing to health examinations.
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Bessie Marshall Benefit Fund Instructions
PDF template
Detailed instructions for members to apply for weekly benefits in case of sickness or injury, with specific eligibility requirements and limitations.
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