Eforms.state.gov
U .S. Dep artm en t of State AP P L IC AT IO N F OR A U.S
WebU .S. Dep artm en t of State AP P L IC AT IO N F OR A U.S . PAS S P O RT DS-1 1 -2 022 Ins tru ction P a ge 1 o f 4 P lease read all in st ru ct io n s first a nd ty pe or p rint in b lack in k to c o m p let e th is fo rm .
Actived: 3 days ago
REQUEST FOR AUTHENTICATIONS SERVICE Estimated Burden: …
WebU.S. Department of State REQUEST FOR AUTHENTICATIONS SERVICE DS-4194 01-2023 Page 1 of 2 USE OF THIS FORM This form is used by individuals, institutions, and government agencies to request authentication and/or apostille certificates under the
MEDICAL HISTORY AND EXAMINATION
WebSubmit the DS-1843 and other documentation via email in PDF format to [email protected] (preferred), or by fax to the Medical Records Department at 202-647-0292. VII: Medical Examiner comments on significant patient medical history and items checked "yes" on page 2/section II. Use additional pages if needed.
DS-5511 Affidavit for the Surviving Spouse or Next of Kin
WebA U.S. Consular officer may only release the personal effects of the decedent to a person who has qualified legally to take care of the decedent's estate or, in appropriate circumstances, to the next of kin. Providing the information in the affidavit is voluntary, but, failure to complete this form will require the person claiming to be next-of
REQUEST FOR OVERSEAS U.S. CITIZEN VITAL RECORDS …
WebThe information solicited on this form may be made available as a routine use to other government agencies and private contractors to assist the U.S. Department of State in issuing certificates under the Seal of the U.S. Department of State and requests for related services, and for law enforcement,
MEDICAL CLEARANCE UPDATE
WebMEDICAL CLEARANCE UPDATE. Bureau of Medical Services, Room L101, SA-1, Washington, DC 20522-0102. MEDICAL CLEARANCE UPDATE. TO BE FILLED OUT BY EXAMINEE OR PARENT/GUARDIAN DATE (mm-dd-yyyy) 1a. Legal Name of Examinee (Last, First, MI) 8. Agency of Employee/Applicant/Sponsor STATE USAID FCS FAS U.S. …
CERTIFICATION OF FOSTER CHILD STATUS
WebSend DS-5111, Certification for Foster Child Status, to the HR Service Center at 1-843-202-3807. The child is unmarried and is under age 26 or over age 26 and incapable of self-support because of a disability that existed before age 26. The child lives with me in a regular parent-child relationship. I contribute regular and substantial support
DEPARTMENT OF STATE DRUG TESTING POLICY
WebDepartment of State DEPARTMENT OF STATE DRUG TESTING POLICY Name . Signature . Date (mm-dd-yyyy) . DS-7663 09-2017 . The Department of State (Department), as a consequence of its leading role in the development and implementation of
MEDICAL QUESTIONNAIRE FOR ASSESSMENT OF …
WebIf you have any questions, please call MED Domestic Programs at 202-663-2508. This form should be e-mailed as a scanned pdf to [email protected] or sent to medically secure fax 202-663-3673. Attn.: Domestic Programs Bureau of Medical Services 2401 E Street N.W. SA-1 Washington, DC 20522-0101. Email.
EMPLOYMENT APPLICATION FOR LOCALLY EMPLOYED STAFF …
WebPRIVACY AND PAPERWORK REDUCTION ACT STATEMENTS (For U.S. Citizens and Legal Permanent Residents of the U.S.) AUTHORITIES The information is sought pursuant to The Foreign Service Act of 1980, as amended, and 22 U.S.C. 2669(c). PURPOSE The information solicited on this form will be used to establish your eligibility and …
EMPLOYEE STATEMENT CONCERNING FEHB COVERAGE …
WebIf employee is terminating FEHB coverage, forward completed SF-2810 to HR Service Center at [email protected]. If applicable, forward completed SF-2809 to HR Service Center at [email protected]. Note: Please ensure the SF-50 is completed before forwarding the forms for processing. DS-5112. 03-2023.
COMMON LAW MARRIAGE DECLARATION FORM
WebAuthorized Official (Please Print) 4. Name and Address of Agency of Retirement System. 6. Signature of Authorized Agency Official. Employing offices must add a copy of the common law marriage declaration (without the supporting documents) to the employee’s Official Personnel Folder or equivalent personnel file and send a copy to the FEHB Carrier.
WRITTEN CONSENT TO RELEASE OF PERSONAL …
WebThe Act also permits - but does not require - the Department to share such information in various established common circumstances, such as when we engage with U.S. and foreign government authorities in connection with your case and when we work with various entities and individuals in emergency situations. The purpose of this form is to allow
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