INSTRUCTIONS: Use this form to apply to be a leave recipient under Public Law of the medical emergency and appropriate documentation of the medical duration of the condition. After completing this form, forward through recipients. Approval as a leave recipient does not guarantee that leave will be. 1. NAME (Last, First, Middle Initial) 2.

2022年11月28日 · If a LIDDA determines that a person meets the criteria for a targeted NF HCS transition slot and the person or LAR wants to enroll in HCS, the diversion coordinator requests a targeted NF HCS transition slot for the person by completing and submitting Form 1046, Request for HCS Adult NF Transition Slot, per the form’s instructions.

Many Departmental forms are now available online to better serve USDA employees and customers. The majority of these forms are used for administrative purposes. Most of the forms on this list will need to be downloaded in order to function fully.

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Information on DHS Applications and Forms grouped by category.

You must use this form to claim a refund of the excise tax paid. For more information, see Important Notice N-22-1, Suspension of Certain Taxes on Motor Fuel and Diesel Motor Fuel Beginning June 1, 2022, or visit our website (see Need help?) and search: fuel.

FT-946/1046 (6/22) For the motor vehicles or equipment you own, indicate how many of each type that uses motor fuel (MF) or diesel motor fuel (DMF). If you do not own any of the following types of equipment, enter N/A in the box where indicated. If the fuel was used in a commercial motor boat, airplane, snowmobile, or all-terrain

To provide Texas Department of Criminal Justice (TDCJ), Texas Juvenile Justice Department (TJJD) and Juvenile Probation Department (JPD) staff a method to notify HHSC when an incarcerated person received inpatient services in a medical institution.

Place this form on top of the Statement of Ownership application packet. This form is required when paying for multiple applications with one check, thereby enabling us to match funds with applications.