Desk Reference to Wisconsin s Domestic Partnership Laws

Size: px
Start display at page:

Download "Desk Reference to Wisconsin s Domestic Partnership Laws"

Transcription

1 Desk Reference to Wisconsin s Domestic Partnership Laws Table of Contents I. Selected Portions of Chapter 40 Page Chapter 40: Public Employee Trust Fund Definitions Benefit assignments and corrections Retirement annuities Annuity options Lump sum payments Health care coverage Long-term care coverage Duty disability and death benefits; protective occupation participants State deferred compensation plan II. Domestic Partnership (Chapter 770) III. Selected Statutes (Chapters ) Chapter 50: Uniform Licensure Certification of certain adult family homes Licensure of certain adult family homes Residential care apartment complexes (2d) Special provisions relating to regulation of community-based residential facilities (accompaniment or visitation) (2d) Special provisions applying to licensing and regulation of nursing homes (accompaniment or visitation) Certain admissions to facilities Rights of residents in certain facilities Rules and standards Admission to and care in a hospice for certain incapacitated persons Accompaniment or visitation vii

2 Chapter 51: State Alcohol, Drug Abuse, Developmental Disabilities and Mental Health Act Records Chapter 66: General Municipality Law Provision of insurance Chapter 69: Collection of Statistics Definitions Powers and duties of state registrar Disclosure of information from vital records Penalties Chapter 77: Taxation of Forest Croplands; Real Estate Transfer Fees; Sales and Use Taxes; County, Transit Authority, and Special District Sales and Use Taxes; Managed Forest Land; Recycling Surcharge; Local Food and Beverage Tax; Local Rental Car Tax; Premier Resort Area Taxes; State Rental Vehicle Fee; Dry Cleaning Fees; Southeastern Regional Transit Authority Fee Exemptions from fee Chapter 101: Department of Commerce C Regulation of Industry, Buildings and Safety Fees Chapter 102: Worker s Compensation Death benefit; law enforcement and correctional officers, fire fighters, rescue squad members, diving team members, national or state guard members and emergency management personnel Additional death benefit for children, state fund Dependents Attorney general shall represent state and commission Chapter 103: Employment Regulations Family or medical leave Employee s cash bonds to be held in trust duty of employer; penalty Chapter 109: Wage Payments, Claims and Collections When wages payable; pay orders Chapter 146: Miscellaneous Health Provisions Health care records; definitions viii

3 Chapter 155: Power of Attorney for Health Care Definitions Power of attorney for health care instrument; execution; witnesses Power of attorney for health care instrument; form Revocation of power of attorney for health care Chapter 157: Disposition of Human Remains Autopsy Anatomical gifts Chapter 243: General Provisions Relating to Fraudulent Conveyances and Contracts Wisconsin basic power of attorney for finances and property Chapter 252: Communicable Diseases Health insurance premium subsidies Medical leave premium subsidies Chapter 301: Corrections Community residential confinement Intensive sanctions program Notification of victims and witnesses about prisoner escapes Access to information concerning sex offenders Chapter 302: Prisons; State, County and Municipal Notification prior to expiration of sentence Chapter 304: Paroles and Pardons Release to parole or extended supervision from state prisons and house of correction Notice of pardon application Chapter 321: Department of Military Affairs Service members civil relief; state active duty Chapter 342: Vehicle Title and Anti-Theft Law Fees Involuntary transfers Chapter 614: Insurance Fraternals Members and applicants in fraternals Chapter 700: Interests in Property Creation of joint tenancy ix

4 Chapter 851: Probate Definitions and General Provisions Domestic partner Net estate Surviving domestic partner Chapter 852: Intestate Succession Basic rules for intestate succession Assignment of home to surviving spouse or surviving domestic partner Chapter 853: Wills Revocation Premarital will or predomestic partnership will Chapter 854: Transfers at Death General Rules Revocation of provisions in favor of former spouse or former domestic partner Chapter 859: Probate Claims Priority of payment of claims and allowances Chapter 861: Probate Family Rights Assignment of home to surviving spouse or surviving domestic partner Allowance to family during administration Selection of personalty by surviving spouse or surviving domestic partner Special allowance for support of spouse or domestic partner and support and education of minor children Exemption of property to be assigned to surviving spouse or surviving domestic partner Chapter 867: Probate Summary Procedures Summary settlement of small estates Chapter 895: Damages, Liability, and Miscellaneous Provisions Regarding Actions in Courts Plaintiff in wrongful death action Chapter 905: Evidence Privileges Husband-wife and domestic partner privilege x

5 Chapter 949: Awards for the Victims of Crimes Definitions Computation of award Chapter 971: Criminal Procedure Proceedings Before and After Trail Commitment of persons found not guilty by reason of mental disease or mental defect Chapter 980: Sexually Violent Person Commitments Notice concerning supervised release or discharge IV. Understanding Domestic Relationships in Wisconsin by Howard A. Sweet V. Wisconsin s New Domestic Partnership Law by Attorney Ruth J. Irvings VI. Wisconsin Domestic Partnership Protections Reference Guide by Fair Wisconsin VII. County Clerk and Register of Deeds Domestic Partnership Reference Guide compiled by Fair Wisconsin VIII. Information on Domestic Partnerships by Wisconsin Department of Employee Trust Funds xi

6

Household, Income and Asset Information This application MUST BE FULLY COMPLETE. Applicant Name (this is you) City/ Town: State: Zip Code:

Household, Income and Asset Information This application MUST BE FULLY COMPLETE. Applicant Name (this is you) City/ Town: State: Zip Code: Falmouth Housing Corporation Falmouth Community, LLC 704 FHC LLC FHC Edgerton Drive, Inc. 704 Main LLC 704 Main Street Falmouth, MA 02540 Tel. (508)540-4009 Fax. (508)548-6329 Household, Income and Asset

More information

GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2017

GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2017 S GENERAL ASSEMBLY OF NORTH CAROLINA SESSION SENATE BILL Finance Committee Substitute Adopted // PROPOSED HOUSE COMMITTEE SUBSTITUTE S-PCS-TM- D Short Title: Military Retiree State Income Tax Relief. (Public)

More information

Full Name: Current Address: Apt #: City: State: Zip: Phone:

Full Name: Current Address: Apt #: City: State: Zip: Phone: Updated: 08/01/2014 Rental Application To be completed by office staff: Date Application Rec d Time Application Rec d Signature of Staff member receiving application Please print or type: Full Name: Current

More information

APPROPRIATIONS COMMITTEE 2017 COMMITTEE ACTION INDEX BILL NUMBER SUBJECT DATE OF HEARING/ DISCUSSION

APPROPRIATIONS COMMITTEE 2017 COMMITTEE ACTION INDEX BILL NUMBER SUBJECT DATE OF HEARING/ DISCUSSION BILL NUMBER SUBJECT DATE OF HEARING/ DISCUSSION HB 2002 Exempting the division of legislative post audit from the monumental building surcharge. DATE OF FINAL ACTION BY FULL COMMITTEE 1/23/17 Be passed

More information

Overview of Estate Planning Practice

Overview of Estate Planning Practice Overview of Estate Planning Practice Richard S. Kinyon Genevieve M. Moore Excerpted from California Estate Planning (Cal CEB) Continuing Education of the Bar California 1.1 I. ESTATE PLANNING PROCESS Estate

More information

Section 11 Probate Glossary

Section 11 Probate Glossary Section 11 Probate Glossary 2012 Investors Empowerment Academy, LLC 119 Abatement A proportional diminution or reduction of the pecuniary legacies, when there are not sufficient funds to pay them in full.

More information

PROBATE IN NEVADA WHAT, WHY, AND HOW by Layne T. Rushforth

PROBATE IN NEVADA WHAT, WHY, AND HOW by Layne T. Rushforth WHAT, WHY, AND HOW by Layne T. Rushforth 1. What is Probate?: Probate generally refers to the court proceeding required to formalize the transfer of the assets 1 belonging to a deceased person ( decedent

More information

HOUSING AUTHORITY OF GLOUCESTER COUNTY 100 Pop Moylan Blvd, Deptford, NJ PRE-APPLICATION FOR ADMISSION AND RENTAL ASSISTANCE GENERAL INFORMATION

HOUSING AUTHORITY OF GLOUCESTER COUNTY 100 Pop Moylan Blvd, Deptford, NJ PRE-APPLICATION FOR ADMISSION AND RENTAL ASSISTANCE GENERAL INFORMATION DATE: HOUSING AUTHORITY OF GLOUCESTER COUNTY 100 Pop Moylan Blvd, Deptford, NJ 08096 PRE-APPLICATION FOR ADMISSION AND RENTAL ASSISTANCE GENERAL INFORMATION APPLICATION NUMBER (Office Use): APPLICANT NAME:

More information

PROBATE QUESTIONNAIRE

PROBATE QUESTIONNAIRE CATHERINE E. DAVEY, J.D., LL.M. Post Office Box 941251 Maitland, Florida 32794-1251 Telephone (407) 645-4833 Facsimile (407) 645-4832 PROBATE QUESTIONNAIRE 1. LEGAL NAME OF DECEDENT: PERMANENT RESIDENCE

More information

Crime Victim Compensation Applicants,

Crime Victim Compensation Applicants, Crime Victim Compensation Applicants, When applying to our program please ensure your application is complete along with an attached copy of the crime report (if available) in order to process your claim.

More information

Tax Credit Housing Application

Tax Credit Housing Application Trailside Heights I, II, III/Lumen Park T: 907.222.1733 F: 907.222.1738 TTY: 711 Trailside2@VOA.org www.voa.org/trailside Heights www.voa.org/lumen park Instructions for completing the application: Please

More information

6. The legal home where a person has a true, fixed, and permanent place of dwelling and to which the person intends to return when absent

6. The legal home where a person has a true, fixed, and permanent place of dwelling and to which the person intends to return when absent CHAPTER 7: THE PARTICIPANTS AND THE PROPER COURT MATCHING a. Letters Testamentary b. tickler system c. registrar d. probate (of a will) e. jurisdiction f. in rem jurisdiction g. disbursements h. venue

More information

County of Chester Office of the Clerk of Courts and the Office of Adult Probation

County of Chester Office of the Clerk of Courts and the Office of Adult Probation County of Chester Office of the Clerk of Courts and the Office of Adult Probation Annual Financial Statement Audit Valentino F. DiGiorgio, III, Controller OFFICE OF THE CLERK OF COURTS / ADULT PROBATION

More information

Disability Insurance Claim Packet Instructions

Disability Insurance Claim Packet Instructions Claim Packet Instructions Your Disability Benefit Claim This packet contains the forms necessary to apply for disability benefits. It also addresses common questions about Disability claims. Please save

More information

Applicant Name(s): Address: Street Apt.# City State Zip

Applicant Name(s): Address: Street Apt.# City State Zip Return to: NORTON VILLAGE APARTMENTS 2145 Norton Street Rochester, New York 14609 For office use only: Apt. Size: Ant. Lease Date: RHA: DSS: APPLICATION FOR APARTMENT AT: NORTON VILLAGE Date *Applications

More information

County of Chester Office of the Clerk of Courts and the Office of Adult Probation

County of Chester Office of the Clerk of Courts and the Office of Adult Probation County of Chester Office of the Clerk of Courts and the Office of Adult Probation Annual Financial Statement Audit Norman MacQueen, Controller OFFICE OF THE ANNUAL FINANCIAL STATEMENT AUDIT AS OF DECEMBER

More information

Application for Housing Assistance

Application for Housing Assistance Main Office (352)567-0848 Fax number (352)567-6035 Hearing Impaired Dial 7-1-1 for Florida relay 36739 S.R. 52, Suite 108, Dade City Florida 33525 Terrie V. Staubs Executive Director Application for Housing

More information

WHAT HAS THE LEGISLATURE DONE TO US NOW? (DON T WORRY IT S NOT TOO BAD!) 2011 TEXAS PROBATE AND TRUST LEGISLATIVE UPDATE

WHAT HAS THE LEGISLATURE DONE TO US NOW? (DON T WORRY IT S NOT TOO BAD!) 2011 TEXAS PROBATE AND TRUST LEGISLATIVE UPDATE WHAT HAS THE LEGISLATURE DONE TO US NOW? (DON T WORRY IT S NOT TOO BAD!) 2011 TEXAS PROBATE AND TRUST LEGISLATIVE UPDATE Statutory Changes Affecting Probate, Guardianships, Trusts, Powers of Attorney,

More information

New Design Benefit Definitions & Reimbursements

New Design Benefit Definitions & Reimbursements ADVICE AND CONSULTATION IN OUT-OF Office Consultation This service provides the opportunity to discuss with an attorney any personal legal problems that are not specifically excluded. The Plan Attorney

More information

ELDER & DISABILITY LAW CLINIC CLIENT INFORMATION WORKSHEET (TO BE COMPLETED BY CLIENT PRIOR TO INITIAL CONSULTATION)

ELDER & DISABILITY LAW CLINIC CLIENT INFORMATION WORKSHEET (TO BE COMPLETED BY CLIENT PRIOR TO INITIAL CONSULTATION) ELDER & DISABILITY LAW CLINIC CLIENT INFORMATION WORKSHEET (TO BE COMPLETED BY CLIENT PRIOR TO INITIAL CONSULTATION) PART 1 General Information Name of Client: Date: Current Address: County: Is this a

More information

NYS BOARD OF REAL PROPERTY SERVICES RP-467-Ins (8/06)

NYS BOARD OF REAL PROPERTY SERVICES RP-467-Ins (8/06) NYS BOARD OF REAL PROPERTY SERVICES RP-467-Ins (8/06) INSTRUCTIONS FOR THE APPLICATION FOR THE PARTIAL REAL PROPERTY TAX EXEMPTION FOR SENIOR CITIZENS EXEMPTION (AND FOR ENHANCED SCHOOL TAX RELIEF [STAR]

More information

NYS BOARD OF REAL PROPERTY SERVICES

NYS BOARD OF REAL PROPERTY SERVICES NYS BOARD OF REAL PROPERTY SERVICES RP-467-Ins (9/08) LP INSTRUCTIONS FOR THE APPLICATION FOR THE PARTIAL REAL PROPERTY TAX EXEMPTION FOR SENIOR CITIZENS EXEMPTION (AND FOR ENHANCED SCHOOL TAX RELIEF [STAR]

More information

County of Chester Office of the Clerk of Courts and the Office of Adult Probation

County of Chester Office of the Clerk of Courts and the Office of Adult Probation County of Chester Office of the Clerk of Courts and the Office of Adult Probation Annual Financial Statement Audit Norman MacQueen, Controller OFFICE OF THE CLERK OF COURTS / ADULT PROBATION ANNUAL FINANCIAL

More information

Accident Benefits Claim Instructions

Accident Benefits Claim Instructions Claim Instructions Your Accident Benefit Claim This packet contains the forms necessary to apply for. Every space on these forms should be filled in to avoid delay in processing your application. If a

More information

APPLICATION FOR APARTMENT AT: CHATHAM GARDENS

APPLICATION FOR APARTMENT AT: CHATHAM GARDENS Return to: Chatham Gardens 150 Kelly Street Rochester, New York 14605 For office use only: Apt. Size: Ant. Lease : RHA: DSS: APPLICATION FOR APARTMENT AT: CHATHAM GARDENS *Applications are placed in order

More information

Pasco County Housing Authority. Application for Housing Assistance

Pasco County Housing Authority. Application for Housing Assistance Pasco County Housing Authority Main Office (352)567-0848 36739 S.R. 52, Suite 108, Dade City Florida 33525 Terrie Staubs Fax number (352)567-6035 Executive Director Hearing Impaired Dial 7-1-1 for Florida

More information

GLOSSARY. Compiled by Carolyn Paseneaux

GLOSSARY. Compiled by Carolyn Paseneaux GLOSSARY Compiled by Carolyn Paseneaux AB TRUST A trust giving a surviving spouse or mate a life estate interest in property of a deceased spouse or mate. It is used to save eventual taxes on the estate.

More information

ESTATE PLAN CLIENT WORKBOOK

ESTATE PLAN CLIENT WORKBOOK ESTATE PLAN CLIENT WORKBOOK When completing these pages, you do NOT have to relist any items that you feel are already in the hands of GCD. 533705/1/03500/94608 I. CLIENT PERSONAL DATA First Name Middle

More information

42 USC NB: This unofficial compilation of the U.S. Code is current as of Jan. 4, 2012 (see

42 USC NB: This unofficial compilation of the U.S. Code is current as of Jan. 4, 2012 (see TITLE 42 - THE PUBLIC HEALTH AND WELFARE CHAPTER 46 - JUSTICE SYSTEM IMPROVEMENT SUBCHAPTER IX - DEFINITIONS 3791. General provisions (a) Definitions As used in this chapter (1) criminal justice means

More information

This act shall be known and may be cited as the "Senior Citizens Rebate and Assistance Act."

This act shall be known and may be cited as the Senior Citizens Rebate and Assistance Act. 4751-1. Short title This act shall be known and may be cited as the "Senior Citizens Rebate and Assistance Act." 4751-2. Declaration of policy In recognition of the severe economic plight of certain senior

More information

BUDGET STATUS REPORT FOR OPERATING FUNDS As of March 31, General Fund Revenues

BUDGET STATUS REPORT FOR OPERATING FUNDS As of March 31, General Fund Revenues BUDGET STATUS REPORT FOR OPERATING FUNDS As of March 31, 2016 General Fund Revenues Tax collections through March 2016 as a percentage of budget are just about even with those through March 2015. Current

More information

OREGON PUBLIC SAFETY SYSTEM SURVEY DOC Responses (N=4) April 2010

OREGON PUBLIC SAFETY SYSTEM SURVEY DOC Responses (N=4) April 2010 OREGON PUBLIC SAFETY SYSTEM SURVEY DOC Responses (N=) April 2010 Report by the Crime and Justice Institute at Community Resources for Justice INTRODUCTION Faced with implementing unprecedented reductions

More information

Acting as an Executor

Acting as an Executor Acting as an Executor 7 th Edition Mary Randolph, J.D. Chapter 1 Overview... 1 Learning Objectives... 1 Introduction... 1 What Executors Do... 1 What Trustees Do... 2 Your Legal Duty... 3 Payment for Serving

More information

Chelsea Housing Authority 54 Locke Street Chelsea, Massachusetts 02150

Chelsea Housing Authority 54 Locke Street Chelsea, Massachusetts 02150 THIS BOX IS FOR OFFICE USE ONLY STANDARD APPLICATION FOR FEDERAL-AIDED PUBLIC HOUSING. Date of receipt: Time of Receipt: Control Number: Barrier Free: First Floor: Elderly/Handicapped: Bedrooms: Race:

More information

Form 1-2, Estate Planning Questionnaire (for Married Clients Where Both Spouses Will Be Represented)

Form 1-2, Estate Planning Questionnaire (for Married Clients Where Both Spouses Will Be Represented) Form 1-2, Estate Planning Questionnaire (for Married Clients Where Both Spouses Will Be Represented) Estate Planning Questionnaire In anticipation of our meeting scheduled for, if at all possible, it would

More information

Acting as an Executor

Acting as an Executor Acting as an Executor Mary Randolph, J.D. Chapter 1 Overview... 1 Learning Objectives... 1 Introduction... 1 What Executors Do... 1 What Trustees Do... 2 Your Legal Duty... 3 Payment for Serving as an

More information

For purposes of this article only, annuity is defined as a policy or. contract that is a private agreement or an investment contract or an insurance

For purposes of this article only, annuity is defined as a policy or. contract that is a private agreement or an investment contract or an insurance (1) Repeal Section 50960. 50960. Definitions. (a) For purposes of this article only, annuity is defined as a policy or contract that is a private agreement or an investment contract or an insurance policy

More information

Chapter 134 TAXATION. Income Limits Beginning 7/1/07

Chapter 134 TAXATION. Income Limits Beginning 7/1/07 Chapter 134 TAXATION [HISTORY: Adopted by the Town Board of the Town of Skaneateles as indicated in article histories. Amendments noted where applicable.] ARTICLE I Senior Citizens Tax Exemption [Adopted

More information

FIDUCIARY LIABILITY COVERAGE PART

FIDUCIARY LIABILITY COVERAGE PART FIDUCIARY LIABILITY COVERAGE PART I. INSURING AGREEMENTS Fiduciary Liability The Insurer shall pay Loss on behalf of the Insureds resulting from a Fiduciary Claim first made against the Insureds during

More information

2003 American Medical Association All Rights Reserved

2003 American Medical Association All Rights Reserved Reproduction and use of this form by physicians and their staff is permitted. Any other use, duplication or distribution of this form by any other party requires the prior written approval of the American

More information

HUDSON SPECIALTY INSURANCE COMPANY Employed Ancillary Provider Application for surplus lines coverage

HUDSON SPECIALTY INSURANCE COMPANY Employed Ancillary Provider Application for surplus lines coverage HUDSON SPECIALTY INSURANCE COMPANY Employed Ancillary Provider Application for surplus lines coverage - If a question does not apply to you, write N/A. Do not leave any questions unanswered. - Include

More information

MINNESOTA CRIME VICTIMS REPARATIONS CLAIM FORM Complete and submit to:

MINNESOTA CRIME VICTIMS REPARATIONS CLAIM FORM Complete and submit to: Date Received: MINNESOTA CRIME VICTIMS REPARATIONS CLAIM FORM Complete and submit to: Claim Number: (Office Use Only) Minnesota Crime Victims Reparations Board 445 Minnesota Street, Suite 2300 St. Paul

More information

References are to section numbers and form numbers except as noted.

References are to section numbers and form numbers except as noted. Subject Index References are to section numbers and form numbers except as noted. A Abatement, 2.29(4), 4.24(3) Accounts (Bank) See also Assets; Final Account; Inventory Generally, 3.17(3d), 4.13(5) Savings

More information

STATUTORY DURABLE POWER OF ATTORNEY

STATUTORY DURABLE POWER OF ATTORNEY STATUTORY DURABLE POWER OF ATTORNEY Author s Comments: This Durable Power of Attorney is based on the Connecticut Statutory Short Form Power of Attorney Act, CGS 1-42 to 1-56. You will notice this form

More information

The Social Security Administration requires the following information:

The Social Security Administration requires the following information: When A Death Occurs The time immediately following the death of a loved one can be days of intense sorrow and emotional stress. The Funeral Director may act as an advisor on many of the immediate problems;

More information

SOCIAL HOUSING ACCOMMODATION REGULATION

SOCIAL HOUSING ACCOMMODATION REGULATION Province of Alberta ALBERTA HOUSING ACT SOCIAL HOUSING ACCOMMODATION REGULATION Alberta Regulation 244/1994 With amendments up to and including Alberta Regulation 146/2017 Office Consolidation Published

More information

Adult and Juvenile Correctional Population Projections. Fiscal Years 2016 to 2021 LEGISLATIVE BUDGET BOARD STAFF

Adult and Juvenile Correctional Population Projections. Fiscal Years 2016 to 2021 LEGISLATIVE BUDGET BOARD STAFF LEGISLATIVE BUDGET BOARD Adult and Juvenile Correctional Population Projections Fiscal Years 2016 to 2021 LEGISLATIVE BUDGET BOARD STAFF JUNE 2016 Adult and Juvenile Correctional Population Projections

More information

2. What will happen to my property if I die without a will or trust?

2. What will happen to my property if I die without a will or trust? 1. What is estate planning? Estate planning is the accumulation, the preservation, and the distribution of your assets. It is accomplishing your personal family goals and easing the management of your

More information

ESTATE PLANNING DICTIONARY

ESTATE PLANNING DICTIONARY ESTATE PLANNING DICTIONARY Administrator For estates administered prior to April 1, 2012, the fiduciary appointed by the Probate Court to settle your estate if you die without a Will (intestate). Attorney-in-fact

More information

PFIZER INC LEGAL SERVICES PLAN

PFIZER INC LEGAL SERVICES PLAN PFIZER INC LEGAL SERVICES PLAN FACT SHEET HOW TO GET LEGAL SERVICES To use your Legal Plan, visit our web site at www.legalplans.com or call Hyatt Legal Plans' Client Service Center at 1-800-821-6400.

More information

Bankruptcy 1. WHAT IS A DISCHARGE IN BANKRUPTCY?

Bankruptcy 1. WHAT IS A DISCHARGE IN BANKRUPTCY? Bankruptcy DISCLAIMER: The information contained in this fact sheet is of a general nature and is provided for your assistance. It is not intended as legal advice and is not a substitute for legal counsel.

More information

a. Family b. Elderly/ Handicapped c. Handicapped d. MRVP

a. Family b. Elderly/ Handicapped c. Handicapped d. MRVP LEXINGTON HOUSING AUTHORITY One Countryside Village Lexington, MA 02420 781-861-0900 STANDARD APPLICATION FOR STATE-AIDED HOUSING THIS BOX IS FOR OFFICE USE ONLY Date of receipt: Time of Receipt: Control

More information

Tenant Data Release of Information

Tenant Data Release of Information TH E MUNICIPAL HOUS I NG AGENCY Tenant Data Release of Information For: Applicant's Name Social Security Number I hereby authorize the landlord or landlord's agents to verify the information on the application.

More information

PRIVACY NOTICE THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PRIVACY NOTICE THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. 1NovaMed Surgery Center of Maryville, LLC PRIVACY NOTICE THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW

More information

Probate. Melissa Geist, Operation Assistant Director Karen Yanik, Operation Manager. Civil, Probate and Mental Health Divisions

Probate. Melissa Geist, Operation Assistant Director Karen Yanik, Operation Manager. Civil, Probate and Mental Health Divisions Probate Melissa Geist, Operation Assistant Director Karen Yanik, Operation Manager Civil, Probate and Mental Health Divisions What is Probate? Probate refers to the combined result of all the procedural

More information

ELK COUNTY COMMISSIONERS RELEASE PRELIMINARY 2018 BUDGET

ELK COUNTY COMMISSIONERS RELEASE PRELIMINARY 2018 BUDGET ELK COUNTY COMMISSIONERS RELEASE PRELIMINARY 2018 BUDGET The Elk County Board of Commissioners is presenting the proposed 2018 county operational budget in the amount of $12,644,115 and an overall budget

More information

City of York Paid Firefighter's Pension Fund

City of York Paid Firefighter's Pension Fund Originally Effective April 1, 1947 As Amended And Restated Effective January 1, 2008 Amended Bill No. 9, Ordinance No. 9, Session 2016 Blanktext TABLE OF CONTENTS PREAMBLE... 1 ARTICLE I DEFINITIONS...

More information

UNIVERSITY OF THE PACIFIC CALIFORNIA VOLUNTARY DISABILITY PLAN. Effective Date of Plan: June 24, 1977

UNIVERSITY OF THE PACIFIC CALIFORNIA VOLUNTARY DISABILITY PLAN. Effective Date of Plan: June 24, 1977 UNIVERSITY OF THE PACIFIC CALIFORNIA VOLUNTARY DISABILITY PLAN Effective Date of Plan: June 24, 1977 The provisions of this restatement of the Plan apply to Disability Benefit Periods beginning on or after

More information

BOSTON BAR ASSOCIATION. November 15, 2011 DURABLE POWER OF ATTORNEY SAMPLE PROVISIONS

BOSTON BAR ASSOCIATION. November 15, 2011 DURABLE POWER OF ATTORNEY SAMPLE PROVISIONS BOSTON BAR ASSOCIATION November 15, 2011 DURABLE POWER OF ATTORNEY SAMPLE PROVISIONS I. Gifting A. Limits on Class 1. Power to Make Gifts or Release Interests: To make gifts, grants, or other transfers,

More information

APPLICATION FOR LEASE

APPLICATION FOR LEASE Current Property Name Address City/State/Zip Phone Number FOR OFFICE USE ONLY APPLICATION RECEIVED DATE: APPLICATION RECEIVED TIME: APARTMENT SIZE: RECEIVED BY: DATE POSTED TO MANUAL WAITING LIST: Please

More information

Medicaid Planning Client Information Summary

Medicaid Planning Client Information Summary Medicaid Planning Client Information Summary Morton Law Firm, PLLC Estate Planning, Asset Protection & Elder Law 132 Fairmont St. Clinton, Mississippi 39056 (601)925-9797 (phone) (601)925-9774 (fax) rmorton@mortonlaw.com

More information

LOBBY REGISTRATION AMENDMENT (For 2017 Registrants)

LOBBY REGISTRATION AMENDMENT (For 2017 Registrants) LOBBY REGISTRATION AMENDMENT (For 2017 Registrants) PG 1PG COVER SHEET Form AREG Instruction Guide explains how to fill out this form. 2 1 Number of Schedules filed: A Schedule C filed: Yes No B Filer

More information

CALIFORNIA DURABLE POWER OF ATTORNEY (California Probate Code Section 4401)

CALIFORNIA DURABLE POWER OF ATTORNEY (California Probate Code Section 4401) CALIFORNIA DURABLE POWER OF ATTORNEY (California Probate Code Section 4401) NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER OF

More information

LOBBY REGISTRATION FOR 2018 (For use through December 31, 2018)

LOBBY REGISTRATION FOR 2018 (For use through December 31, 2018) LOBBY REGISTRATION FOR 2018 (For use through December 31, 2018) COVER SHEET PG 1 The Form REG Instruction Guide explains how to fill out this form. 1 Number of Schedules filed: A B Filer ID OFFICE USE

More information

Homestead Exemptions

Homestead Exemptions Homestead Exemptions Property Tax Code General Homestead Exemption (Owner-occupied) Sec. 15-175 (In all counties except Cook County) Alternative General Homestead Exemption (Cook County only) Sec. 15-176

More information

THE HOUSING AUTHORITY

THE HOUSING AUTHORITY THE HOUSING AUTHORITY OF THE CITY OF LAWRENCEVILLE 502 Glenn Edge Drive Lawrenceville, Georgia 30046 www.lawrencevilleha.org Lejla Slowinski Executive Director Phone: (770) 963-4900 LAWRENCEVILLE HOUSING

More information

requirement. Interested persons may submit written comments relevant to the proposal on or before 5:00 P.M., March 5, These

requirement. Interested persons may submit written comments relevant to the proposal on or before 5:00 P.M., March 5, These LAW AND PUBLIC SAFETY DIVISION OF CRIMINAL JUSTICE OFFICE OF THE STATE MEDICAL EXAMINER Proposed Readoption: N.J.A.C. 13:49 Authorized by: John Krolikowski, M.D., Acting State Medical Examiner Authority:

More information

SENATE APPROPRIATIONS COMMITTEE FISCAL NOTE

SENATE APPROPRIATIONS COMMITTEE FISCAL NOTE BILL NO. House Bill 1929 PRINTER NO. 3810 AMOUNT See Fiscal Impact DATE INTRODUCED November 17, 2017 FUND General Fund PRIME SPONSOR Representative Marsico DESCRIPTION AND PURPOSE OF BILL House Bill 1929

More information

RETURN THIS COPY TO JOHN HANCOCK. City/Town: State: Zip:

RETURN THIS COPY TO JOHN HANCOCK. City/Town: State: Zip: HIPAA Authorization ATTN: R-02-B Long-Term Care PO Box 852 Boston, MA 02117-0852 Insured Name : Phone: 800-233-1449 Fax: 617-572-7979 Claim Number: Insured Street Address: RETURN THIS COPY TO JOHN HANCOCK

More information

Hyde Park Apartments 336 W. 36 th Street Kansas City, Missouri Office: Fax:

Hyde Park Apartments 336 W. 36 th Street Kansas City, Missouri Office: Fax: Dear Applicant: Hyde Park Apartments 336 W. 36 th Street Kansas City, Missouri 64111 Office: 816-756-2710 Fax: 816-531-5813 Email: hydepark@dalmarkgroup.com Thank you for your interest in our community.

More information

City of York Police Pension Fund

City of York Police Pension Fund Originally Effective March 21, 1930 As Amended And Restated Effective January 1, 2008 Blanktext TABLE OF CONTENTS PREAMBLE... 1 ARTICLE I DEFINITIONS... 2 Section 1.1 References 2 Section 1.2 Actuarial

More information

HCV Certification Form

HCV Certification Form HCV Certification Form Instructions for completing this form: Complete this form IN INK. You must answer ALL questions front and back. A packet must be completed for every change of income or household,

More information

NEW JERSEY OFFICE OF ADMINISTRATIVE LAW N.J.A.C. Expiration Report

NEW JERSEY OFFICE OF ADMINISTRATIVE LAW N.J.A.C. Expiration Report TITLE 01 ADMINISTRATIVE LAW July 2018 07/08/2018 012 UNEMPLOYMENT BENEFIT AND STATE PLAN TEMPORARY DISABILITY CASES 07/08/2018 012A PRIVATE PLAN TEMPORARY DISABILITY INSURANCE CASES 1 TITLE 02 AGRICULTURE

More information

Arapahoe Housing Authority

Arapahoe Housing Authority Arapahoe Housing Authority 208 Sixth Street, Box 0 Arapahoe, NE 68922 Telephone: (308) 962-7669 Fax: (308) 962-3669 Email: araphous@atcjet.net Office Use Only: Date of Application: Time of Application:

More information

MOSERS Continued Dependent Life Insurance for a Disabled Child Instructions

MOSERS Continued Dependent Life Insurance for a Disabled Child Instructions Continued Dependent Life Insurance Instructions Your application for consists of four forms. Every space should be filled in to avoid delay in processing your application. If a section does not apply,

More information

Internal Revenue Code Section 121(d)(10) Exclusion of gain from sale of principal residence.

Internal Revenue Code Section 121(d)(10) Exclusion of gain from sale of principal residence. Internal Revenue Code Section 121(d)(10) Exclusion of gain from sale of principal residence. CLICK HERE to return to the home page (a) Exclusion. Gross income shall not include gain from the sale or exchange

More information

Estate Planning Concepts

Estate Planning Concepts Estate Planning Concepts Hartman Private Law LLP 2009 2 Estate Planning Do you have or need an estate plan? Old Documents/Non-Georgia Documents Estate planning foundation Four primary estate planning documents

More information

Law Enforcement/ Public Safety Officers

Law Enforcement/ Public Safety Officers Law Enforcement/ Public Safety Officers The 11-member OPERS Board of Trustees is responsible for the administration and management of OPERS. Seven of the 11 members are elected by the groups that they

More information

STATE OF FLORIDA LEGAL SERVICES PLAN

STATE OF FLORIDA LEGAL SERVICES PLAN STATE OF FLORIDA LEGAL SERVICES PLAN FACT SHEET HOW TO GET LEGAL SERVICES To use your Legal Plan, visit our website at www.legalplans.com or call Hyatt Legal Plans' Client Service Center at 1-800-821-6400.

More information

Funeral Planning Resource Guide for Families

Funeral Planning Resource Guide for Families Funeral Planning Resource Guide for Families Carroll Hospice social workers, chaplains and bereavement staff are available to you and your loved ones as you make arrangements. This guide will provide additional

More information

Do you need any special accommodations due to your inability to communicate, read or write? YES NO. initial

Do you need any special accommodations due to your inability to communicate, read or write? YES NO. initial PASADENA COMMUNITY DEVELOPMENT COMMISSION WL - PERSONAL DECLARATION FOR RENTAL ASSISTANCE BENEFITS 649 NORTH FAIR OAKS AVE. SUITE 202 PASADENA, CA 91103 PHONE (626) 744-8300 FAX (626) 744-8330 Please complete

More information

Application for Reinstatement United Home Life Insurance Company 225 S. East St. P.O. Box 7192 Indianapolis, IN

Application for Reinstatement United Home Life Insurance Company 225 S. East St. P.O. Box 7192 Indianapolis, IN Application for Reinstatement United Home Life Insurance Company 225 S. East St. P.O. Box 7192 Indianapolis, IN 46207-7192 1-800-428-3001 Policy Number Proposed Insured Spouse (If spouse coverage) Premium

More information

ORDINANCE NO. WHEREAS, the Agreement contains several changes to the Police Officer's Retirement System; and

ORDINANCE NO. WHEREAS, the Agreement contains several changes to the Police Officer's Retirement System; and ORDINANCE NO. AN ORDINANCE OF THE CITY OF HOLLYWOOD, FLORIDA, INCORPORATING IN THE CODE OF ORDINANCES THE APPROPRIATE PENSION PROVISIONS OF THE COLLECTIVE BARGAINING AGREEMENT BETWEEN THE BROWARD COUNTY

More information

HONORABLE SERVICE. All Funds

HONORABLE SERVICE. All Funds HONORABLE SERVICE All Funds New Jersey law (N.J.S.A. 43: 1-3 et seq.) stipulates that the receipt of retirement benefits is expressly conditioned upon the rendering of honorable service by the member (i.e.

More information

Japan. International Estate Planning Guide. Individual Tax and Private Client Committee. Contact: Shimon Takagi. White & Case LLP Tokyo, Japan

Japan. International Estate Planning Guide. Individual Tax and Private Client Committee. Contact: Shimon Takagi. White & Case LLP Tokyo, Japan Japan International Estate Planning Guide Individual Tax and Private Client Committee Contact: Shimon Takagi White & Case LLP Tokyo, Japan stakagi@tokyo.whitecase.com Updated 9/2012 TABLE OF CONTENTS I.

More information

NOTICE OF PRIVACY PRACTICES

NOTICE OF PRIVACY PRACTICES NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. If you have any

More information

YOUR GROUP VOLUNTARY TERM LIFE BENEFITS

YOUR GROUP VOLUNTARY TERM LIFE BENEFITS Release R99 YOUR GROUP VOLUNTARY TERM LIFE BENEFITS FOR EMPLOYEES OF: McAlister Oil, LLC CLASS(ES): All Eligible Employees REVISION EFFECTIVE DATE: September 1, 2018 PUBLICATION DATE: October 3, 2018 NOTICE(S)

More information

STATE EMPLOYEES ASSOCIATION OF NC LEGAL SERVICES PLAN

STATE EMPLOYEES ASSOCIATION OF NC LEGAL SERVICES PLAN STATE EMPLOYEES ASSOCIATION OF NC LEGAL SERVICES PLAN FACT SHEET HOW TO GET LEGAL SERVICES To use your Legal Plan, visit our website at www.legalplans.com or call Hyatt Legal Plans' Client Service Center

More information

Monthly Financials November 30, 2017

Monthly Financials November 30, 2017 Monthly Financials November 30, 2017 Combining All Fund Revenue, Expenditures & Monthly Financials Table of Contents Budget Comparison 1 Bank Account Balances 2 Summary of Government wide Statement of,

More information

Hand & Microsurgery Medical Group, Inc. HIPAA NOTICE AND ACKNOWLEDGEMENT

Hand & Microsurgery Medical Group, Inc. HIPAA NOTICE AND ACKNOWLEDGEMENT Hand & Microsurgery Medical Group, Inc. HIPAA NOTICE AND ACKNOWLEDGEMENT Acknowledgement: I acknowledge that I have received the attached Notice of Privacy Practice. Patient or Personal Representative

More information

Cypress Grove Homes of McGehee Unit Availability Policy

Cypress Grove Homes of McGehee Unit Availability Policy RE: Cypress Grove Homes of McGehee Unit Availability Policy Dear Applicant: We appreciate your initial interest in renting a unit at Cypress Grove Homes of McGehee. In an effort to facilitate your housing

More information

SECTION 8. EMPLOYEE COMPENSATION AND BENEFITS - FISCAL YEAR

SECTION 8. EMPLOYEE COMPENSATION AND BENEFITS - FISCAL YEAR SECTION 8. EMPLOYEE COMPENSATION AND BENEFITS - FISCAL YEAR 2016-2017 Statement of Purpose This section provides instructions for implementing the Fiscal Year 2016-2017 salary and benefit adjustments provided

More information

Estate Planning Basics

Estate Planning Basics Estate Planning Basics PRESENTED BY Brian S. Feldman Attorney at Law WICZER SHELDON & JACOBS, LLC 500 Skokie Boulevard, # 325 Northbrook, IL 60062 ( 8 4 7 ) 8 4 9-4 8 5 0 www.wsjlaw.com What is an estate

More information

A. Administration means one or more of the following administrative duties or activities with respect to a Plan:

A. Administration means one or more of the following administrative duties or activities with respect to a Plan: FIDUCIARY LIABILITY CLAUSE I. INSURING CLAUSES A. The Underwriters shall pay on behalf of the Insureds all Loss resulting from any Claim first made against any Insured and reported in writing

More information

COUNTY SOCIAL SERVICES POLICIES AND PROCEDURES FOR COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 HIPAA

COUNTY SOCIAL SERVICES POLICIES AND PROCEDURES FOR COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 HIPAA COUNTY SOCIAL SERVICES POLICIES AND PROCEDURES FOR COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 HIPAA 1 Recommended by ISP Committee of CSS on October 22 nd, 2014 Amended

More information

BUDGET STATUS REPORT FOR OPERATING FUNDS As of June 30, General Fund Revenues

BUDGET STATUS REPORT FOR OPERATING FUNDS As of June 30, General Fund Revenues BUDGET STATUS REPORT FOR OPERATING FUNDS As of June 30, 2016 General Fund Revenues Tax collections through June 2016 as a percentage of budget are even with those through June 2015. Current year tax collections

More information

Rock Island County, Illinois Circuit Clerk. Financial and Compliance Report Year Ended November 30, 2010

Rock Island County, Illinois Circuit Clerk. Financial and Compliance Report Year Ended November 30, 2010 Rock Island County, Illinois Circuit Clerk Financial and Compliance Report Year Ended November 30, 2010 Contents Independent Auditor s Report 1 2 Financial Statements Statement of assets and liabilities

More information

RENTAL HOUSING APPLICATION HB PROPERTY MANAGEMENT

RENTAL HOUSING APPLICATION HB PROPERTY MANAGEMENT PRIMARY APPLICANT First Name Last Name Middle Initial Social Security Number Date of Birth Driver License Number Driver License State Expiration Date Spouse s First Name Last Name Middle Initial Social

More information

State of Minnesota Office of the State Auditor

State of Minnesota Office of the State Auditor State of Minnesota Office of the State Auditor Rebecca Otto State Auditor Bylaw Guide For a Lump-Sum Volunteer Fire Relief Association Affiliated with a City Fire Department February 06, 2012 Revised July

More information

Winnebago County Housing Authority 3617 Delaware Street Rockford, IL Phone: (815) Fax: (815)

Winnebago County Housing Authority 3617 Delaware Street Rockford, IL Phone: (815) Fax: (815) Winnebago County Housing Authority 3617 Delaware Street Rockford, IL 61102 Phone: (815) 963-2133 Fax: (815) 316-2860 Winnebago County Rental Housing Support Program efficiency-3 bedroom units, which applicants

More information