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Disability parking certificate... There is a fee of 5 per commercial disability parking certificate requested. Commercial parking certificates are issued for three-year periods. You may qualify for two 2 certificates if you do not have disability license plates. Parking certificates are valid until the last day of the month indicated on the certificate. Residents of other states must make an application for Permanent Certificates in their home states. HOW DO I USE THE DISABILITY PARKING CERTIFICATE or the passenger. mirror is illegal and very dangerous. Certificates cannot be issued to taxi or limousine services as their disabled patrons should have their own personal parking certificates. Knowingly allowing the misuse of the certificate or disability license plates shall result in the cancelation of disability parking privileges. MISUSE OF PARKING PRIVILEGE Any unauthorized use or reproduction of the Department issued Disability Parking Certificate is subject to the revocation of parking privilege. The disability must be re-certified before a new or subsequent parking certificate will be issued. Persons with a permanent disability are issued a 6 Year Certificate. TDD 651 282-6555 Web dvs. dps. mn.gov Applications new and renewal for commercial disability parking certificates must be made in a written request format explaining the proposed certificate usage in conjunction with the transportation of disabled individuals as well as internal controls i.e. ensuring proper accountability of the certificates. MINNESOTA DEPARTMENT OF PUBLIC SAFETY DRIVER AND VEHICLE SERVICES Print Form FOR CENTRAL OFFICE USE ONLY 445 Minnesota Street St* Paul MN 55101-5164 Phone 651 297-3377 Web dvs. Two certificates are not an option if applicant has disability license plates If applying for replacement check reason Lost Stolen Damaged Other Please Explain I hereby certify the above information is complete and accurate to the best of my knowledge. I also give permission to the Health Professional to supply the information requested* Date Signature Certificate Type HEALTH PROFESSIONAL MEDICAL STATEMENT SECTION Fee 5 ea* Temporary 1 to 6 Months Must Specify Short Term 7 to 12 Months No Fee Long-Term 13 to 71 Months 6-year Certificate For permanent disabilities g Certificate Expiration Date / Month IMPORTANT If no date is indicated the certificate will be issued for the minimum duration of certificate type Year The applicant must meet one or more of the definition s of a physically disabled person described below Check which definition s the applicant meets Listing symptoms such as Back Pain Leg Pain etc* will require further explanation causing delays in issuance. Incomplete/missing information will cause significant delays in issuance Deputy Stamp Has a cardiac condition to the extent that the applicant s functional limitations are classified in severity as Class III or Class IV according to the standards set by the American Heart Association* Uses portable oxygen Has an arterial oxygen tension PAO2 of less than 60 mm/Hg on room air at rest.

Ar birth certificate applicati... ARKANSAS DEPARTMENT OF HEALTH VITAL RECORDS Slot 44 4815 West Markham Street Little Rock AR 72205 Date BIRTH CERTIFICATE APPLICATION Only Arkansas births are recorded in this office. Overnight shipping is available for an additional fee. AMOUNT OF MONEY ENCLOSED Walk-in You may order a certified copy of the birth record by coming into this office. Orders are accepted for same day issuance from 8 00 A. M. until 4 00 P. M. Monday through Friday. The office is located at 4815 West Markham St. Little Rock AR 72205. There are a limited number of birth records filed in this office prior to February 1 1914. The fee is 12. 00 for the first copy ordered and 10. 00 for each additional copy of the same record. The fee must accompany the application* Send check or money order payable to the Arkansas Department of Health. DO NOT SEND CASH. Of the total fee you send 12. 00 will be kept to cover search charges if no record of the birth is found. Only the names and dates listed will be searched for the 12. 00 fee. Names and other dates submitted later will require an additional 12. 00 non-refundable fee. Mail this application a copy of your photo id and the money to the address above. Please allow 4-6 weeks for delivery. List Below All Possible Birth Dates and Names Under Which the Certificate May be Registered* Type or Print First Name Middle Name Last Name 1 Full Name at Birth Date of Birth Month Day City or Town Year County Sex Age Last Birthday State Place of Birth Name of Hospital or Street Address Full Name of Father 5. Full Maiden Name of Mother Name Before Marriage If this child has been adopted please give original name if known* If this is a delayed certificate when was it filed What is your relationship to the person whose certificate is being requested Is the person whose certificate is being requested still living Yes No Signature and telephone number of person requesting this certificate. X All requests for certificates require photo identification* Certificates may also be ordered by the following methods Internet www. vitalchek. com* All internet orders are expedited* The service fee and the certificate fee are charged to your debit or credit card Visa Master Card Discover or American Express. Overnight shipping is available for an additional fee. HOW MANY 1st copy costs 12. 00 Each additional copy costs 10. 00 OR Telephone Toll free 866 209-9482. All telephone orders are expedited* The service fee and the certificate fee are charged to your debit or credit card Visa Master Card Discover or American Express. Overnight shipping is available for an additional fee. AMOUNT OF MONEY ENCLOSED Walk-in You may order a certified copy of the birth record by coming into this office. Orders are accepted for same day issuance from 8 00 A. M. until 4 00 P. M. Monday through Friday. The office is located at 4815 West Markham St* Little Rock AR 72205. Please order family history and genealogy by mail or internet. Please PRINT the name and address of the person who is to receive this request on the line below.

Blank death certificate bihar... State of Connecticut Department of Public Health Vital Records 6/05;10/1/09 VS-7 APPLICATION FOR STILLBIRTH CERTIFICATE NAME OF STILLBORN. Print the entire name as it currently appears on the fetal

Ct fillable death certificate... STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH (DPH) Request for a Certified Copy of a Death VS-39DTW Revised: 9/6/2011 Certificate from the Town of Death Vital Records Office DO NOT MAIL CASH OR

Chelsea piers certificate of o... D E P A R T M E N T O F C O N S U M E R & R E G U L A T O R Y A F F A I R S Certificate of Occupancy GENERAL INFORMATION A Certificate of Occupancy ( C of O ) does not take the place of any license

Ecampus fiu 2011 form BIRTH Application for Certified Copy of Maryland Birth Record Maryland Department of Health and Mental Hygiene Division of Vital Records BIRTH By my signature below, I state that I am the person I

Delaware certificate of public... Certificate of Public Review Application Kit State of Delaware Delaware Health Resources Board Bureau of Health Planning and Resources Management Delaware Division of Public Health Jesse Cooper 417

Nj certificate public applicat... Mail entire application to NJ Department of Environmental Protection Compliance and Enforcement Office of Local Environmental Management Mail Code 09-01A P. O. Box 420 Trenton New Jersey 08625-0420 Any questions please call Suzanne Conway 609 633-1389 Michael DeTalvo 609 984-6825 or fax 609 292-3991. APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY FOR SOLID WASTE COLLECTION AND/OR DISPOSAL RETURN THIS FORM TO NJDEP County Environmental Waste Enforcement P. Facility must be included in the county s solid waste management plan. UNLESS A-901 HAS BEEN APPROVED AND THE APPLICATION IS ADMINISTRATIVELY COMPLETE YOUR APPLICATION FOR A CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY WILL BE RETURNED. NOTE Do not include a payment with this application The Department of Treasury will send a bill equivalent to one quarter 1/4 of one percent of a company s estimated gross operating revenue. Mail entire application to NJ Department of Environmental Protection Compliance and Enforcement Office of Local Environmental Management Mail Code 09-01A P. TARIFF COVER PAGE 1. Application This Tariff contains the terms and conditions and schedules of rates governing the services furnished by a public utility and holder/applicant of a Certificate of Public Convenience and Necessity for the collection of solid waste. The Utility s principal locating is Company Street Address Mailing Address Company President/Owner Contact Person Telephone Fax Registered Agent Name Address Telephone Fax 2. Territory Served Counties of If you would like to operate in all counties of New Jersey enter All counties of New Jersey By the filing of this Tariff Document the Utility named above agrees to conform with all rules and regulations promulgated by the District Solid Waste Management Plans and the NJ Department of Environmental Protection in accordance with N.J.S.A. CERTIFICATE OF PUBLIC CONVENIENCE NECESSITY APPLICATION CHECKLIST Name Application completed and notarized Questions 8-19 must be answered by both corporations and LLC. Experience per question 30 of application* Copy of N*J*S*A. 13 1E-126 et seq. A-901 approval* Please note that both NJDEP and the Division of Law A-901 Unit must be notified prior to any changes in ownership including change of address owners officers directors and key employees. Itemized list of equipment per question 31 of application* Applicant may apply for Certificate of Public Convenience and Necessity before he/she possesses equipment. For a corporation attach copy of FILED Certificate of Incorporation* 5a* If not incorporated under laws of the State of New Jersey furnish copy of authority to do business in New Jersey and copy of corporate charter. 5b. For Limited Liability Company FILED Certificate of Formation. 5c* If applicable FILED copy of registration of FICTITIOUS/ALTERNATE name. 5d. For proprietorship registration of trade name. Tariff* Statement of financial condition* Proof of Insurance see item 4. Keep copy of entire application* For Solid Waste Facility Certificate landfills incinerators transfer stations only Solid Waste Facility Permit contact Tom Byrne for more information 609 984-6812.

Blank birth certificate pdf tn... TENNESSEE DEPARTMENT OF HEALTH OFFICE OF VITAL RECORDS APPLICATION FOR NEW CERTIFICATE OF BIRTH BY SUBSEQUENT MARRIAGE OF PARENTS Read instructions on the back before completing this form. SECTION

Certificate of election to dis... Department of Commerce, Community, and Economic Development Division of Corporations, Business, and Professional Licensing Corporations Section PO Box 110808 Juneau AK 99811-0808 ARTICLES OF INCORPORATION

Idaho certificate authority fo... APPLICATION FOR CERTIFICATE OF AUTHORITY For Profit Click here to clear form Instructions on Back of Application The undersigned Corporation applies for a Certificate of Authority and states as follows 1. The name of the corporation is 2. The name which it shall use in Idaho is 3. It is incorporated under the laws of 4. APPLICATION FOR CERTIFICATE OF AUTHORITY For Profit Click here to clear form Instructions on Back of Application The undersigned Corporation applies for a Certificate of Authority and states as follows 1. The name of the corporation is 2. The name which it shall use in Idaho is 3. It is incorporated under the laws of 4. Its date of incorporation is 5. The address of its principal office is 6. The address to which correspondence should be addressed if different from item 5 is 7. The street address of its registered office in Idaho is and its registered agent in Idaho at that address is 8. The names and respective business addresses of its directors and officers are Title Office Name Address Business Address Customer Acct Dated if using pre-paid account Typed Name Capacity The signer must be a director or an officer of the corporation* g corp forms corp forms appforcertofauthorityprofit. pmd Revised 06/2005 Secretary of State use only Signature Web Form INSTRUCTIONS If the document is incorrect is there a telephone number to reach you for corrections Note Complete and submit the application in duplicate. This application must be accompanied by a certificate of existence or goodstanding dated within 90 days from the date of filing with this office. A certified copy of the articles of incorporation or a certificate of tax status will NOT be accepted* 1. Lines 1 2 - Enter the name of the corporation exactly as it reads from the certificate of existence from the domestic state. Complete item 2 only if 1 the corporation must adopt a fictitious name to avoid a conflict with an existing name on the records of the Secretary of State or 2 the corporation s true name does not include one of the words of incorporation required by section 30-1-401 Idaho Code and such word is added to the true name in item 2. A corporate name must include corporation incorporated company limited or any abbreviation thereof* If a fictitious name is adopted to avoid a conflict attach a resolution of the board of directors adopting the assumed name. 2. Lines 3 4 - Enter the domestic state and its date of incorporation* You must include the day month and year. This date must match the date on the certificate of existence if one is given* 3. Line 5 - Enter the address of its principal office. designated to receive service of process upon litigation* This person must be located in Idaho at a street address. If you do not have anyone to act as your registered agent in Idaho you may contact the Secretary of State for a list of companies which offer such representation in Idaho. president secretary and directors. 7. Sign and date the application* Please identify the name of the signer by typing his/her name below the signature and indicate in what capacity they are signing.

Louisiana birth certificate on... STATE OF LOUISIANA ACKNOWLEDGMENT OF PATERNITY AFFIDAVIT CHILD BORN OUTSIDE OF MARRIAGE (FOR USE IN HOSPITAL) NOTICE: You must read and initial the NOTICE OF ALTERNATIVES, RIGHTS AND RESPONSIBILITIES

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