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County # Facility Name Address Line 1 City Zip Code Telephone …
Jan 1, 2018 … SIGNATURE HEALTHCARE AT. HERITAGE HALL REHAB & WELL. 331 SOUTH
MAIN STREET. LAWRENCEBURG. 40342. (502) 839-7246 LAUREN. SWORD.
LP LAWRENCEBURG, LLC. 94. 94. 10. 05/01/2017. 04/30/2018. EEB. BALLARD
. 100011 LIFE CARE CENTER OF LACENTER. 252 W. 5TH ST …
# Facility Name Address Line 1 City Zip Code County Telephone …
Dec 1, 2017 … BLUEGRASS CARE & REHABILITATION. CENTER. 3576 PIMLICO PARKWAY.
LEXINGTON. 40517. FAYETTE. (859) 272-0608 TRINA. MANUEL-JAGOE. LP
LEXINGTON PIMLICO, LLC. 124. 124. 11/01/2017. 10/31/2018. EEB. 100024
BOURBON HEIGHTS NURSING HOME 2000 SOUTH MAIN STREET.
City Safety Call for Projects Grant Form 2018 – wsdot
against state, tribal or local government involving a crash at the location(s)
mentioned in the data. Requester Information. Name. Company/Agency Name.
Address. City. State. Zip Code. Phone No. Email. Crash Data Requested. Date
Range. 1/1/2012 – 12/31/2016. City or County. Specific Roadway -or- Roadway
Tricentennial Neighborhood Grant Applicaiton – City of New Orleans
Zip Code: Phone Number: Email Address: Years: Months: Circle one. Yes. No.
Please provide the 501(c)3 or federal tax ID number of the association: How long
have you lived in the neighborhood? Are you 18 years of age or older?
Neighborhood or Community Association: Application deadline: Monday,
January 8th, 2018.
5123, 2018 City Estimated Income Tax for … – State of Michigan
Michigan Department of Treasury – City Tax Administration. 5123 (02-17). Issued
under authority of Public Act 284 of 1964, as amended. See instructions for filing
guidelines. 2018 City Estimated Income Tax for Individuals. NOTE: If you are
married and plan to file your annual return as “married, filing separately,” DO
National Medal of Technology – United States Patent and Trademark …
The United States Patent and Trademark Office. Expiration Date 4/30/2018. U.S.
Department of Commerce. PHONE. FAX. E-MAIL. NAME #3. TITLE.
Pronunciation. COMPANY / NON-PROFIT. ADDRESS. CITY. STATE. ZIP CODE.
PHONE. FAX. E-MAIL. NAME #4. TITLE. Pronunciation. COMPANY / NON-
Carrier Virginia Cities/Counties in which Carriers Intend to Offer On …
Sep 15, 2017 … Virginia Cities/Counties in which Carriers Intend to Offer On-Exchange. Coverage
in 2018. CareFirst. BlueChoice, Inc. Covers the following: Arlington County.
Fairfax County (following zip codes only):. 22003, 22009, 22015, 22027, 22030,
22031, 22032, 22034, 22035, 22036, 22037, 22039, 22041, 22042, …
2018 Form OR-19, Annual Report of Nonresident … – Oregon.gov
Pass-through entity (PTE) name. PTE federal employer identification number (
FEIN). PTE address. Name of contact person. Type of entity: This form is due by
the end of the second month after the end of the entity's tax year. The due date for
entities using a calendar 2018 tax year is February 28, 2019. City. State. ZIP code
state of arizona 2018 supplemental form for … – Benefit Options
Jan 3, 2018 … 1. 2018.01.03_2018_Beneficiaries_Form. STATE OF ARIZONA. 2018
SUPPLEMENTAL FORM FOR. BENEFICIARIES AND DEPENDENTS. STREET
ADDRESS. CITY, STATE. ZIP CODE. IMPORTANT! Enrollment should be
completed online at yes.az.gov. This form should only be used if you are unable
2018 Form 100-ES – Corporation Estimated Tax – Franchise Tax Board
City. State. ZIP code. California corporation number. Attention: Owner's or
representative's name. California Secretary of State file number. Telephone.
6101183. 6101183. 6101183. Form 100-ES 2017. Form 100-ES 2017. Form 100-
ES 2017. IF NO PAYMENT IS DUE, DO NOT MAIL THIS FORM. IF NO PAYMENT
IS DUE, …
2018 Out-of-State Dealer License Application – PA Dept. of Agriculture
kennel license type and kennel location must have a separate application. I.
PART 1: Applicant Information. Name of Kennel to Appear on the. Out-of-State
Dealer Kennel License. Kennel License #. County. Kennel Address (physical
location of kennel). Twp/Borough. (street address, city, state, zip code). Please
check box if …
2018 kennel license application – PA Dept. of Agriculture
I. PART 1: Applicant Information. 1. The information requested below must be
supplied for every person who holds an ownership interest in the kennel. Name
of Kennel to Appear on Kennel License. Kennel License #. County. Kennel
Address (physical location of kennel). Twp./Borough. (street address, city, state,
2018 Winter Flag Football Registration Form – City of Fort Lauderdale
MILLS POND. WINTER FLAG FOOTBALL. 2018. 2018 Registration Guide.
REGISTRATION. December 26th – January 29th. LEAGUE OFFICE. (954) 828-
8946. (954) 828-8943. GAME INFO & FIELD … your completed registration form
with payment to: City of Fort Lauderdale, Parks and Recreation … State:______
Zip Code: …
2018 NVGAG Sponsorship Form* Company or Individual Name …
2018 NVGAG Sponsorship Form*. Company or Individual Name: Address: City:
State: Zip: Sponsor Main Contact: Name and Title: Daytime Telephone: Email:
Sponsor Fulfillment Contact (responsible for providing logo, ad copy, etc.) Name
and Title: Daytime Telephone: Email:.
Region County Activity Expiration Date Permit Permit Name Address …
Date. Permit. Permit Name. Address. City. Zip Code Contact. Phone. ASH.
Cleveland. Landfarm. 9/5/2018. SRU100038. Environmental Soils, Inc. PO BOX
295. Lattimore. 28089 Matt Rice. 704-434-. 0075. FAY. Sampson. Landfarm. 1/31
/2022. SRU600035. Carlisle Farms. 1555 Holland Rd. Autryville. 28318. Rick.
TWO YEAR FEE $12.00 2018 – Dog Training Firearms … – Maine.gov
State of Maine, Department of Inland Fisheries & Wildlife. 284 State Street,
Station #41, Augusta, Me. 04333. Make checks payable to: Treasurer State of
Maine. TWO YEAR FEE $12.00. 2018 – Dog Training Firearms Use. Name. Date
of Birth. Mailing Address street or box # town/city state zip code. (state & zip code
2018 D-41 ES – Office of Tax and Revenue
.00. Estate or trust's federal employer ID number. Estate or trust name. Fiduciary's
name and title. Fiduciary's address (number, street and suite/apartment number if
applicable). City. State. Zip Code + 4. 2018 D-41ES. Estimated Payment for
Fiduciary Income Tax. LY. Vendor ID#0002. Rev. 05/17. Tax period ending (
Employer Name Address City State Zip Code Approved Date – NH.gov
Jan 4, 2018 … Date 1/10/2018. School-to-Work. Pre-Approved Work Sites. Page 1 Of 36.
Employer Name. Address. City. State Zip Code Approved Date. A & E CUSTOM
COFFEE ROASTERY & TEA. 135 STATE ROUTE 101A. AMHERST. NH. 03031.
02/24/2017. A AND K LEARNING CENTER INC. 95 BREWERY LANE.
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