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Nevada homestead declaration f... DECLARATION OF HOMESTEAD FOR RECORDING STAMP Assessor s Parcel Number APN or Assessor s Manufactured Home ID Number Recording Requested by and Mail to Name Address City/State/Zip DO NOT WRITE IN THIS AREA Check One Married filing jointly Widowed Single Person Multiple Single Persons Head of Family By Wife filing for joint benefit of both By Husband filing for joint benefit of both Other describe Regular Home Dwelling/Manufactured Home Condominium Unit Other Name on Title of Property do individually or severally certify and declare as follows is/are now residing on the land premises or manufactured home located in the city/town of more particularly described as follows set forth legal description and commonly known street address or manufactured home description I/We claim the land and premises hereinabove described together with the dwelling house thereon and its appurtenances or the described manufactured home as a Homestead. In witness Whereof I/we have hereunto set my hand/our hands this day of 20. Signature Print or type name here STATE OF NEVADA COUNTY OF This instrument was acknowledged before me on date Notary Seal Person s appearing before notary Signature of notarial officer CONSULT AN ATTORNEY IF YOU DOUBT THIS FORM FITS YOUR PURPOSE. NOTE Do not write in 1-inch margin. Rev.Feb 2010. Signature Print or type name here STATE OF NEVADA COUNTY OF This instrument was acknowledged before me on date Notary Seal Person s appearing before notary Signature of notarial officer CONSULT AN ATTORNEY IF YOU DOUBT THIS FORM FITS YOUR PURPOSE* NOTE Do not write in 1-inch margin* Rev*Feb 2010.

Declaration of mailing form SHORT TITLE CASE NUMBER DECLARATION OF MAILING INSTRUCTIONS Only a person who is age 18 years or older and not a party to this action can serve document copies by mail. Code Civ. Proc. 1013a. An unsigned copy of this Declaration of Mailing must be attached to and mailed with the copies. DATED LACIV 143 Rev. 09/08 LASC Approved 03-04 TYPE OR PRINT NAME OF PERSON WHO DID MAILING SIGNATURE OF PERSON WHO DID MAILING Print Save Code Civ. Proc. 1013 Clear. After the copies are deposited in the mail the person who mailed them must fill out and sign this form attached as the last page of the originals for filing. Code Civ* Proc* 1013 b. WARNING Falsifying this form can be a felony punishable by imprisonment in state prison* Pen* Code 118 126 1. I am employed in or a resident of the county in which this mailing occurred and not a party to this action* At the time of mailing I was at least 18 years of age or older 2. I am readily familiar with the practice at the residence or business address shown below for collection and processing of correspondence for mailing with the United States Postal Service which causes it to be sealed and deposited with said Postal Service with the postage prepaid the same day it is mailed or placed for collection and processing* 3. My residence business address and telephone number are as follows ADDRESS TELEPHONE NUMBER CITY STATE AND ZIP CODE I served the below document s on behalf of name of party personally sealing and mailing with postage prepaid placing for collection and mailing following ordinary by business practices true copies to the addressed as shown on the date and at the place shown in envelope s sealed or to be sealed in the ordinary course of business and addressed as follows DATE MAILED PLACE OF MAILING City and state 5. Exact title s of document s served I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. After the copies are deposited in the mail the person who mailed them must fill out and sign this form attached as the last page of the originals for filing. Code Civ* Proc* 1013 b. WARNING Falsifying this form can be a felony punishable by imprisonment in state prison* Pen* Code 118 126 1. Code Civ* Proc* 1013 b. WARNING Falsifying this form can be a felony punishable by imprisonment in state prison* Pen* Code 118 126 1. I am employed in or a resident of the county in which this mailing occurred and not a party to this action* At the time of mailing I was at least 18 years of age or older 2. I am employed in or a resident of the county in which this mailing occurred and not a party to this action* At the time of mailing I was at least 18 years of age or older 2. I am readily familiar with the practice at the residence or business address shown below for collection and processing of correspondence for mailing with the United States Postal Service which causes it to be sealed and deposited with said Postal Service with the postage prepaid the same day it is mailed or placed for collection and processing* 3.

Declaration of income form NEW YORK STATE DEPARTMENT OF HEALTH Office of Health Insurance Programs Self-Declaration of Income Name App. Reg/Case Social Security Number XXX-XXAddress STREET CITY STATE ZIP CODE Complete the information below only if you have no other way to document your income. All of the boxes below must be checked and all questions answered* Failure to complete this form may result in denial of your application* I get paid in cash. I do not get pay checks. I do not get pay stubs. I cannot get a letter from my employer. Explain why My cash income is How often weekly monthly etc* Current Employer Applicants/Recipients must read the following and sign below I certify that I have no other way to document my income and that all of the above information is true and correct. I understand that this information is to be used to determine eligibility for Public Health Insurance Programs. I understand that program officials may verify information on this form* I also understand that if I intentionally misrepresent my income I may have to repay benefits received and may be prosecuted under State law. Signature of Applicant Date Facilitated Enrollers must read the following and sign below obtain other possible sources of documentation* The information reported on this form was provided solely by the applicant/recipient and reflects the income the applicant reported to me. I did not modify the information in any way. I understand that if I intentionally falsified information on this form or if I assisted the applicant in falsifying any information I may lose my job and may be prosecuted under State law. All of the boxes below must be checked and all questions answered* Failure to complete this form may result in denial of your application* I get paid in cash. I do not get pay checks. I do not get pay stubs. I cannot get a letter from my employer. Explain why My cash income is How often weekly monthly etc* Current Employer Applicants/Recipients must read the following and sign below I certify that I have no other way to document my income and that all of the above information is true and correct. I do not get pay checks. I do not get pay stubs. I cannot get a letter from my employer. Explain why My cash income is How often weekly monthly etc* Current Employer Applicants/Recipients must read the following and sign below I certify that I have no other way to document my income and that all of the above information is true and correct. I understand that this information is to be used to determine eligibility for Public Health Insurance Programs. I understand that this information is to be used to determine eligibility for Public Health Insurance Programs. I understand that program officials may verify information on this form* I also understand that if I intentionally misrepresent my income I may have to repay benefits received and may be prosecuted under State law. I understand that program officials may verify information on this form* I also understand that if I intentionally misrepresent my income I may have to repay benefits received and may be prosecuted under State law. Signature of Applicant Date Facilitated Enrollers must read the following and sign below obtain other possible sources of documentation* The information reported on this form was provided solely by the applicant/recipient and reflects the income the applicant reported to me.

Download fillable of 306 adden... Addendum to Declaration for Federal Employment (OF 306) Indian Health Service Child Care & Indian Child Care Worker Positions Item 15a. Agency Specific Questions Name: Social Security Number:

Ex parte application and decla... Name, Address, and Telephone Number For court use only Superior Court of California County of San Francisco 400 McAllister St. San Francisco, CA 94102 Petitioner: Respondent: Application and Declaration

Indiana financial form FINANCIAL DECLARATION FORM STATE OF INDIANA CIRCUIT AND SUPERIOR COURTS OF PORTER COUNTY IN RE THE MARRIAGE OF Cause Number Petitioner And Respondent In accordance with Local Rule 18 of the Porter Superior Court and Indiana Trial Rules 26 33 34 35 and 37 the undersigned Petitioner or Respondent hereby submits the following VERIFIED FINANCIAL DISCLOSURE STATEMENT Dated I. Further this Financial Declaration Form is considered as a Request for Admissions to the recipient under Trial Rule 35 and should the recipient fail to fully prepare and exchange this statement then the Court may prohibit the party who did not properly complete the Financial the other party on the issues of income expenses assets and liabilities. Date Signature XVI. ATTORNEY S CERTIFICATION I have reviewed with my client the foregoing information including any valuations and attachments and sign this certificate consistent with my obligation under Trial Rule 11 of the Indiana Rules of Procedure. PRELIMINARY INFORMATION Husband Wife Address Soc* Sec* No* Badge/Payroll No* Occupation Employer Birth Date Date of Marriage Date of Physical Separation Date of Filing Children Name Age DOB SSN II. HEALTH INSURANCE INFORMATION Name and Address of health care insurance company Name all persons covered under plan s Weekly cost of total health insurance premium Weekly cost of health insurance premium for children only Name of the children s health care providers The names of the schools and grade level for each child are List any extraordinary health care concerns of any family member List any educational concerns of any family member III. INCOME INFORMATION A. EMPLOYMENT HISTORY Current Employer Telephone No* Length of Employment Job Description Gross Income Per week Bi-weekly Per month Yearly Net Income B. C. Dates of Employment INCOME SUMMARY 1. GROSS WEEKLY INCOME from Salary and wages including commissions bonuses allowances and over-time Note If paid monthly determine weekly income by dividing monthly income by 4. 3 Pensions Retirement Social Security Disability and unemployment insurance Public Assistance welfare AFDC payments etc* Food Stamps Child supports received for any child ren not both of the parties to this marriage Dividends and Interest Rents received All other sources specify TOTAL GROSS WEEKLY INCOME 2. ITEMIZED WEEKLY DEDUCTIONS from gross income State and Federal Income Taxes Medical Insurance Coverage Health Dental Eye Care Psychiatric Compensation per wk/mo/yr Union or other dues Retirement Pension fund Mandatory Optional Profit sharing Mandatory Optional 401 K Mandatory Optional SEP Mandatory Optional IRA Mandatory Optional Child Support withheld from pay not including this case Garnishments itemize on separate sheet Credit Union debts Direct Withdrawals Out of Paychecks Car Payments Life Insurance Disability Insurance Thrift plans Credit Union Savings Bonds Donations Other specify TOTAL WEEKLY DEDUCTIONS 3. WEEKLY DISPOSABLE INCOME A minus B Subtract Total Weekly Deduction from Total Weekly Gross Income IN ALL CASES INVOLVING CHILD SUPPORT Prepare and attach an Indiana Child Support Guideline Worksheet with documentation verifying your income or supplement with such a Worksheet within ten 10 days of the exchange of this Form* IV.

Form 7507 2012 1 Not to be completed when passenger manifests are presented. CBP Form 7507 11/12 Notes and Specifications NOTE 1. DEPARTMENT OF HOMELAND SECURITY U*S* Customs and Border Protection GENERAL DECLARATION Outward/Inward AGRICULTURE CUSTOMS IMMIGRATION AND PUBLIC HEALTH OMB No* 1651-0002 Expires 02/28/2015 See back of form for Paperwork Reduction Act Notice. 19 CFR 122. 43 122. 52 122. 54 122. 73 122. 144 Owner or Operator Marks of Nationality and Registration Departure from Flight No* Date Arrival at Place FLIGHT ROUTING Place Column always to list origin every en-route stop and destination PLACE TOTAL NUMBER OF CREW NUMBER OF PASSENGERS ON THIS STAGE 1 Departure Place Embarking Through on same flight Arrival Place Disembarking NUMBER OF SED s AND AWB s SED s Declaration of Health Persons on board known to be suffering from illness other than airsickness or the effects of accidents as well as those cases of illness disembarked during the flight AWB s For official use only Any other condition on board which may lead to the spread of disease Details of each disinsecting or sanitary treatment place date time method during the flight. If no disinsecting has been carried out during the flight give details of most recent disinsecting Signed if required Crew Member Concerned I declare that all statements and particulars contained in this General Declaration SIGNATURE Authorized Agent or Pilot-in-Command and in any supplementary forms required to be presented with this General Declaration are complete exact and true to the best of my knowledge and that all through passengers will continue/have continued on the flight. An arrival-departure card CBP Form I-94 for each passenger on board shall be presented to the immigration officer at the port of first arrival* List surname given name and middle initial of each crew member in the column headed Total Number of Crew. Air cargo manifests shall be attached hereto. If copies of air waybills/consignment notes are attached their numbers shall be entered on separate cargo manifest CBP Form 7509 to be attached hereto. If copies of air waybills/ consignment notes are not attached to this form a separate cargo manifest CBP Form 7509 completed to show the full information required shall be furnished* If the airline or operator consolidates a shipment with other shipments or encloses the goods in other wrappers or containers either separately or with other goods the changes in packing and/ or marks and numbers must be clearly stated in the air way-bill/consignment note. This section is to be completed only as directed by the U*S* Centers for Disease Control and Prevention CDC in the event of a public health emergency. Conveyance operators should follow established procedures for reporting deaths/ill persons onboard an aircraft as required by 42 CFR Part 71. Third item-- If entry is duplicated it is to be a initialed by person signing the general declaration or b signed by his authorized agent having knowledge of measures applied* This General Declaration and/or attached manifests or air waybills should not bear erasures or corrections except those approved by the proper public authorities concerned nor contain interlineations or several listings on the same line.

8 010 2014 2019 form Childcare Expenses Paid for Joint Child ren 16. City Where Childcare is Provided Page 1 - FORM 8. 010. 5 UNIFORM SUPPORT DECLARATION OF PETITIONER RESPONDENT CO-PETITIONER CO-RESPONDENT OTHER UTCR 8. 010 4 8. 010 7 8. 040 3 8. 040 4 8. 050 1 8. 050 3 Revised 12-1-14 This form is a DECLARATION under penalty of perjury required for support determinations. 010 4 8. 010 7 8. 040 3 8. 040 4 8. 050 1 8. 050 3 Revised 12-1-14 This form is a DECLARATION under penalty of perjury required for support determinations. It must be completed in its entirety signed filed with the court or appropriate administrative agency and served upon the other party or their attorney. IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR COUNTY In the Matter of Petitioner Co-Petitioner and Respondent Co-Respondent. Case No* Judge Assigned Check one box PETITIONER S RESPONDENT S CO-PETITIONER S CO-RESPONDENTS or OTHER UNIFORM SUPPORT DECLARATION OR CSP Case No* SUMMARY INFORMATION COMPLETE THIS PAGE LAST After completing Sections 1 through 5 on Pages 2 through 5 below insert the information and/or total MONTHLY amounts in this Summary Information section* Date of Completion mm/dd/year 1. Number of Joint Children From This Relationship 3. Number of Nonjoint Additional Children 4. Gross Monthly Income From All Sources 5. Receiving Temporary Assistance for Needy Families Yes No 6. Child ren on Oregon Health Plan/Healthy Kids or Other Public Health Plan 7. Social Security or Veteran s Benefits Received for Child ren Person with Disability is Child Me Other Parent 8. Spousal Support RECEIVED by You 10. Mandatory Union Dues Paid 11. Health Care Premiums for Yourself 13. Out-of-Pocket Medical Expenses Paid for Joint Child ren 14. Number of ANNUAL Overnights Child ren Spends With You 15. 5 UNIFORM SUPPORT DECLARATION OF PETITIONER RESPONDENT CO-PETITIONER CO-RESPONDENT OTHER UTCR 8. It must be completed in its entirety signed filed with the court or appropriate administrative agency and served upon the other party or their attorney. INSTRUCTIONS Answer all questions. Items marked with an should be transferred to Page 1. If you are seeking spousal support you need to complete Schedule 1. Attach additional page if needed* IMPORTANT This information will be disclosed to the other party and may be subject to public access. Protections are available using the court s Confidential Information Form process. CHILDREN A. List all JOINT CHILDREN children under the age of 21 born or adopted during this relationship Children Living With Name of Child Age Me Other Parent Other Over 18 Under 21 Attending School Yes No B. List all NONJOINT ADDITIONAL CHILDREN children under the age of 21 born to or adopted by you but not of this relationship. Name YOUR GROSS INCOME A. From Your Employment Description Monthly Amount Gross hourly wage. Average number of hours worked per pay period. x Convert to annual* If paid monthly enter 12. If paid twice monthly enter 24. Every two weeks enter 26.

Texas form declaration 2015 P r o p e r t y Ta x Dealer s Motor Vehicle Inventory Declaration Form 50-244 CONFIDENTIAL Year Send Original to Appraisal District Name and Address Phone area code and number Send Copy to County Tax Office and Address This document must be filed with the appraisal district office and the county tax assessor-collector s office in the county in which your business is located. Do not file this document with the office of the Texas Comptroller of Public Accounts. Location and address information for the appraisal district office in your county may be found at comptroller. texas. gov/propertytax/references/directory/cad* Location and address information for the county tax assessor-collector s office in your county may be found at comptroller. texas. gov/propertytax/references/directory/tac* GENERAL INSTRUCTIONS This declaration is for a dealer of motor vehicles to declare motor vehicle inventory pursuant to Tax Code Section 23. 121. File a declaration for each business location* ALTERNATIVE ELECTION Effective Jan* 1 2014 certain dealers of motor vehicle inventory may elect to file renditions under Tax Code Chapter 22 rather than file declarations and tax statements under Tax Code Chapter 23. Tax Code Section 23. 121 a 3 allows a dealer to make this election if it 1 does not sell motor vehicles that are self-propelled and designed to transport persons or property on a public highway 2 meets either of the following two requirements a the total annual sales from the inventory less sales to dealers fleet transactions and subsequent sales for the preceding tax year are 25 or less of the dealer s total revenue from all sources during that period or b the dealer did not sell a motor vehicle to a person other than another dealer during the preceding tax year and the dealer estimates that the dealer s total annual sales from the dealer s motor vehicle inventory less sales to dealers fleet transactions and subsequent sales for the 12-month period corresponding to the current tax year will be 25 or less of the dealer s total revenue from all sources during that period 3 files with the chief appraiser and the tax collector by Aug. 31 of the tax year preceding Jan* 1 on a form prescribed by the Comptroller a declaration that the dealer elects not to be treated as a dealer under Tax Code Section 23. 121 in the current tax year AND 4 renders the dealer s motor vehicle inventory in the current tax year by filing a rendition with the chief appraiser in the manner provided by Tax Code Chapter 22. A dealer who makes this election must file the election annually with the chief appraiser and the tax collector by Aug. 31 of the preceding tax year so long as the dealer meets the eligibility requirements of law. WHERE TO FILE Each declaration must be filed with the county appraisal district s chief appraiser and a copy of each declaration must be filed with the collector. DECLARATION DEADLINES Except as provided by Tax Code Section 23. 122 l a declaration must be filed not later than Feb.

Transfer tax form 10677068 ASSET TRANSFER TAX DECLARATION P. L 2007 Chapter 100 A5002 N.J.S.A. 54 50-38 New Jersey Division of Taxation Bulk Transfers Box 245 Trenton NJ 08695-0245 Party Information Seller s Name Seller s FID/EIN Purchaser s Name ACTUAL Date of Sale Business Type check one S-Corporation Partnership Form TTD This form may be reproduced Please print or type LLC Corporation Proprietor State of Formation Return type filed to report gain CBT PART NJ1040/1041 NJ1040NR TIN If a gain is declared Line 9 each intended K-1 recipient must complete a declaration. Number of K-1s Realty Location if applicable Block s Street Address Lot s City Calculation of Estimated Tax to nearest dollar State Zip See reverse side for specific line instructions. 1. Consideration / Selling Price 2. Settlement Charges Not to include Mortgage/Loan payoffs 3. Cost After Depreciation 4. Current Year Loss 5. NOL Carryover if allowable 6. IRC Section 1031 Exchange if applicable 7. Gain subtract lines 2 through 6 from line 1 8. Amount of Gain Deferred if applicable 9. Current Year Gain subtract line 8 from line 7 10. Share of Gain if K-1 multiply line 9 by percentage 11. Tax Rate from NJ-1040 Schedule not effective rate. 12. Estimated Tax on Gain Due line 10 multiplied by line 11 Will there be installment proceeds Yes No if yes give details on reverse side. Taxpayer s Declaration I declare that all the information on this declaration is correct. I am aware that if any of the foregoing information provided by me is knowingly false I am subject to punishment. Date Owner/Partner/Member Signature Print Title Rev 04-13 1. 3. 0 or assignee of business assets of any possible claim for State taxes. This directive includes all final business tax returns and payment. Procedure The estimated tax on the gain portion of the escrow to be held at closing is initially calculated by multiplying the gross consideration by the tax rate of the taxpayer. Upon completion of this declaration submission to and review by the Division the estimated tax on the gain portion of the escrow may be reduced appropriately. Upon closing of the transaction the escrow will be held by the transferee s attorney and the estimated tax on the gain portion of the escrow will be demanded by the Division to be applied to the appropriate tax type and year. A confirmation of receipt and the application of the estimated tax payment will be sent to the transferor s attorney. The taxpayer files their year end business tax return claims credit for the payment and pays any additional tax due. They may request a refund or credit if an overpayment exists. Specific Line Instructions for Estimated Tax Calculation Special Note Lines 1 through 9 establish gain* Line 10 assigns share. Line 1 Total sale price or consideration of all assets currently being transferred* Line 2 Total amount of settlement charges to transferor associated with this transaction* Line 3 If fully depreciated enter zero. Line 8 Calculate amount deferred based on installment or short term notes. Line 9 For NJ1065 filers If any member/partner is not an individual or if the number of nonresident member/partners exceeds five 5 stop here and attach the most current membership directory.

Hamilton county verified finan... Clear FINANCIAL DECLARATION LR29-FLOO-402.10 FORM 402 B STATE OF INDIANA COUNTY OF HAMILTON IN RE THE MARRIAGE OF: Petitioner, and Respondent. HUSBAND: Name: Address: Employer: Attorney: Address:

Declaration regarding administ... DECLARATION REGARDING ADMINISTRATION OF OATH AND CONFIRMATION OF IDENTITY AND SOCIAL SECURITY NUMBER In re: (Debtor s Name) Bankruptcy Case No. Date of telephonic or video conference appearance at

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