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SCHEDULE C (Form 5500) Service Provider Information OMB No. 12100110 Department of the Treasury Internal Revenue Service This schedule is required to be filed under section 104 of the Employee Retirement.
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Instructions for Completing this Form To sign up for access to your health information in MyChart please complete this Sign-Up Form and return it to your clinic or to the address shown below. If you would like access to your child or another adult s MyChart information please ask your clinic for the appropriate forms or download them from www. Your Information All sections required please print clearly. Name last...
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MINOR SOURCE OPERATING PERMIT OFFICE OF AIR QUALITY Kawneer Company Inc. 751 International Drive Franklin Indiana 46131 herein known as the Permittee is hereby authorized to operate subject to the conditions contained herein the emission units described in Section A Source Summary of this permit.
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Federal ID Are contributions to the organization tax deductible MO Yes Make Checks Payable to the Illinois Charity Bureau Fund DAY Check all items attached Copy of IRS Return Audited Financial Statements Copy of Form IFC 15. SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR B C NET ASSETS ADDRESS CITY STATE ZIP CODE A B LIABILITIES MAIL C PERCENTAGE GROSS AMTS* AMOUNT D E GOVERNMENT GRANTS MEMBERSHIP DUES E F OTHER...
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