Form P-142OP Eye Care Professional’s Medical Report
INSTRUCTIONS: CONNECTICUT EYE CARE PROFESSIONAL'S MEDICAL REPORT (Form P-142OP)
In order to receive a Connecticut license to operate a public service motor vehicle or service bus, you must have your vision examined by an eye care professional. Your examination is documented using a form P-142OP, which can be found on the website of the government of the state of Connecticut.
Connecticut Eye Care Professional's Medical Report P-142OP Step 1: Enter the date of the incident being addressed in the top right-hand corner.
Connecticut Eye Care Professional's Medical Report P-142OP Step 2: The patient should enter their signature in the first blank box and the date in the second blank box. The form should then be given to the medical professional for completion.
Connecticut Eye Care Professional's Medical Report P-142OP Step 3: Enter the patient's name in the third blank box.
Connecticut Eye Care Professional's Medical Report P-142OP Step 4: Enter the patient's date of birth in the fourth blank box.
Connecticut Eye Care Professional's Medical Report P-142OP Step 5: Enter the patient's telephone number in the fifth blank box.
Connecticut Eye Care Professional's Medical Report P-142OP Step 6: Enter the patient's street address, city, state and zip code in the sixth blank box.
Connecticut Eye Care Professional's Medical Report P-142OP Step 7: Enter the date of the last examination in the seventh blank box.
Connecticut Eye Care Professional's Medical Report P-142OP Step 8: Enter the patient's visual acuity information for both eyes where indicated.
Connecticut Eye Care Professional's Medical Report P-142OP Step 9: Indicate with a check mark whether the patient requires corrective lenses for driving.
Connecticut Eye Care Professional's Medical Report P-142OP Step 10: If both eyes are present, enter the uninterrupted binocular peripheral visual field in the horizontal median where indicated.
Connecticut Eye Care Professional's Medical Report P-142OP Step 11: If only one eye is present, enter the uninterrupted monocular peripheral visual field in the horizontal median where indicated.
Connecticut Eye Care Professional's Medical Report P-142OP Step 12: If the patient's best corrected vision is 20/70 or worse, give a written explanation of the cause where indicated.
Connecticut Eye Care Professional's Medical Report P-142OP Step 13: Answer all remaining questions on the form as instructed.
Connecticut Eye Care Professional's Medical Report P-142OP Step 14: Sign and date the bottom of the form, as well as providing your telephone number and your medical professional license number.
Form K-88 Storage Rates Posting
INSTRUCTIONS: CONNECTICUT STORAGE RATES POSTING (Form K-88)
Connecticut storage facilities for motor vehicles are required to post a form K-88 documenting the standard rates for storage. This document can be obtained from the website of the government of the state of Connecticut.
Connecticut Storage Rates Posting K-88 Step 1: Enter your business name and address in the first blank box.
Connecticut Storage Rates Posting K-88 Step 2: Enter your license number in the second blank box.
Connecticut Storage Rates Posting K-88 Step 3: Enter your business hours in the third blank box.
Connecticut Storage Rates Posting K-88 Step 4: Enter the days and hours when vehicles can be claimed by customers in the fourth blank box.
Connecticut Storage Rates Posting K-88 Step 5: Enter the name of the licensee in the fifth blank box.
Connecticut Storage Rates Posting K-88 Step 6: Enter the number of wreckers in the sixth blank box.
Connecticut Storage Rates Posting K-88 Step 7: Enter the wrecker registration plate numbers in the seventh blank box.
Connecticut Storage Rates Posting K-88 Step 8: Enter the size of the storage lot in the eighth blank box.
Connecticut Storage Rates Posting K-88 Step 9: The table provided below has the standard storage rates. The first line concerns vehicles that are under 20 feet in length. The first column contains the storage rates for 5 days or less inside.
Connecticut Storage Rates Posting K-88 Step 10: The second column concerns the storage rates for more than 5 days inside.
Connecticut Storage Rates Posting K-88 Step 11: The third column concerns the storage rates for 5 days or less outside in a fenced, lighted and protected area.
Connecticut Storage Rates Posting K-88 Step 12: The fourth column concerns the storage rates for more than 5 days outside in a fenced, lighted and protected area.
Connecticut Storage Rates Posting K-88 Step 13: The fifth column concerns the storage rates for 5 days or less in an outside area.
Connecticut Storage Rates Posting K-88 Step 14: The sixth column concerns the storage rates for more than 5 days in an outside area.
Connecticut Storage Rates Posting K-88 Step 15: The second line concerns storage rates for vehicles which are 20 feet to 32 feet long.
Connecticut Storage Rates Posting K-88 Step 16: The third line concerns storage rates for vehicles which are longer than 32 feet.
Form 815 Wholesaler’s Return of Spirits and Vinous Sold and Malt/Cider Liquor Purchased
INSTRUCTIONS: ARIZONA WHOLESALER'S RETURN OF SPIRITS AND VINOUS SOLD AND MALT/CIDER LIQUOR PURCHASED (Form 815)
Arizona wholesalers are required to file a form 815 on a monthly basis to document sales of spirits and wine and malt or cider liquor purchased. This document can be obtained from the website of the Arizona Department of Revenue.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 1: At the top of the page, enter your liquor license number, taxpayer identification number and the month for which you are filing.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 2: Enter all business identifying information required.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 3: On line 1, enter your beginning inventory.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 4: Skip to Schedule A on the second page and document purchases of spirits or vinous and malt/cider liquors received during the month. Transfer the values calculated here to line 2a on the first page.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 5: Enter total gallons received from retailers on line 2b. Enter the sum of lines 2a and 2b on line 3.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 6: Skip to Schedule B on the third page to document tax free sales to military installations. Transfer the values from here to line 4a on the first page.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 7: Skip to Schedule C on the third page to document gallons exported from Arizona. Transfer the values calculated here to line 4b on the first page.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 8: Skip to Schedule D to document sales to and purchases from Arizona wholesalers. Transfer the values calculated here to lines 4c and 4d on the first page.
Arizona Wholesaler's Return Of Spirits And Vinous Sold And Malt/Cider Liquor Purchased 815 Step 9: Complete lines 4e through 11 as instructed. Sign and date the bottom of the form and provide your title.
Verification of Other State Licenses/Registrations
INSTRUCTIONS: ALABAMA VERIFICATION OF OTHER STATE LICENSES
As part of the process of applying for an Alabama license to practice as a physician assistant or anesthesiologist assistant, you must obtain verification from all states in which you have been certified, registered or licensed in this capacity, or have ever applied for this status. This is done by mailing the form discussed in this article to all applicable states. This form can be obtained from the website maintained by the Alabama Board of Medical Examiners.
Alabama Verification Of Other State Licenses Step 1: Print or type your full name on the first blank line.
Alabama Verification Of Other State Licenses Step 2: Enter your signature on the second blank line.
Alabama Verification Of Other State Licenses Step 3: Enter your identifying number in the state of Alabama on the third blank line.
Alabama Verification Of Other State Licenses Step 4: Enter the date on the fourth blank line.
Alabama Verification Of Other State Licenses Step 5: Enter your street address, city, state and zip code on the fifth blank line.
Alabama Verification Of Other State Licenses Step 6: Mail the form to the appropriate medical board of each applicable state for completion. On the first blank line, the person completing the form will enter your name.
Alabama Verification Of Other State Licenses Step 7: On the second blank line, the person completing the form will enter your certificate, registration or license number.
Alabama Verification Of Other State Licenses Step 8: On the third blank line, the person completing the form will enter the date this certificate, registration or license number was issued.
Alabama Verification Of Other State Licenses Step 9: On the fourth blank line, the person completing the form will enter the date on which this certificate, registration or license was terminated.
Alabama Verification Of Other State Licenses Step 10: On the fifth blank line, the person completing the form will enter the reason the certificate, registration or license was terminated.
Alabama Verification Of Other State Licenses Step 11: On the sixth blank line, any derogatory remarks will be entered. On the seventh blank line, any miscellaneous remarks will be entered.
Alabama Verification Of Other State Licenses Step 12: The person completing the form will sign and date it, as well as entering their title and the name of the applicable state board.