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Form A-2 Self Sufficiency Income Chart in Forms Preparation and Data Validation

Form A-2 Self Sufficiency Income Chart in  Forms Preparation and Data Validation

 

INSTRUCTIONS: ALABAMA WIA SELF-SUFFICIENCY INCOME CHART (Appendix A (A-2))

 

 

This article discusses the Alabama Workforce Investment System (WIA) updated self-sufficiency income chart which was revised in 2008. Because the revised guidelines for this chart were implemented after the publication of the Forms Preparation Handbook for that year, it was necessary to update the information following this document's revision on April 25, 2008. The governor's letter requesting these changes and the chart can still be found on the website maintained by the Alabama Department of Economic and Community Affairs.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 1: The first paragraph of the first page explains the purpose of this letter.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 2: The second paragraph discusses the changes that must be made to the Self-Sufficiency Income Chart.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 3: The third paragraph discusses the actions to be taken to implement these changes.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 4: The fourth paragraph, which is located on the second page, contains contact information for obtaining further assistance in implementing these changes.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 5: The third page contains the revised self-sufficiency income charts. Chart A contains the rates for metropolitan areas. All applicable counties falling into this category are listed. In the table provided, the size of the family is listed in the first column.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 6: In the second column, the 100% Lower Living Standard Income Level (LLSIL) is listed.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 7: In the third column, the 200^ Lower Living Standard Income Level rate is listed.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 8: For families who have more than six members, the amount to be added for each additional family member is provided at the bottom of the table.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 9: Table B provides rates for the other 39 Alabama counties not listed above which are classified as non-metropolitan areas. The family size for each rate is listed in the first column.

 

Alabama WIA Self-Sufficiency Income Chart Appendix A (A-2) Step 10: The 100% LLSIL for each family is given in the second column, while the 200% LLSIL is given in the third column.

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Alabama Medical Licensure Commission and Alabama Board of Medical Examiners Change of Address Form

Alabama Medical Licensure Commission and Alabama Board of Medical Examiners Change of Address Form

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Form A-1-PE-9 Application for Professional Engineer Licensure

Form A-1-PE-9 Application for Professional Engineer Licensure

 

INSTRUCTIONS: ALABAMA APPLICATION FOR PROFESSIONAL ENGINEER LICENSURE (Form A-1-PE-9)

 

 

To apply for a professional engineer license in Alabama, file the form discussed in this article. This document can be obtained from the website maintained by the Alabama Board of Licensure for Professional Engineers and Land Surveyors.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 1: On line 1, enter your full legal name.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 2: On line 2, enter both your residential and firm address. Indicate which is preferred for mailing correspondence by placing an X in the appropriate box. Provide the telephone number for both addresses, as well as your email address.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 3: On line 3, enter your date of birth.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 4: On line 4, enter your Social Security number.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 5: On line 5, indicate whether you are applying for licensure by comity or exam with a check mark. If comity, skip to line 6. If exam, indicate whether you failed the professional engineer in another state with a check mark. If so, give the state and the number of times, complete line 6, then skip to line 10.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 6: On line 6, document as instructed Alabama or other states where you passed the Fundamentals of Engineering (FE) or professional engineer exams. 

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 7: On line 7, give the state and date of your first professional engineer licensure, as well as the date to which it is current.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 8: On line 8. list other states in which you are licensed.

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 9: On line 9, indicate whether you hold a current NCEES record.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 10: Answer lines 10 through 15 by checking "Yes" or "No" as applicable.

 

Alabama Application For Professional Engineer Licensure A-1-PE-9 Step 11: Document your undergraduate and graduate record in section 16, your experience in section 17, verification of your experience in section 18, and references in section 19. Complete sections 20 through 22 as instructed, then have section 23 certified by a notary public.

 

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Form IB14 State Employee Plan Change Form

Form IB14 State Employee Plan Change Form

 

INSTRUCTIONS: ALABAMA STATE EMPLOYEE PLAN CHANGE FORM (Form IB14)
 
Alabama state employees who wish to change their health insurance coverage do so by filing a form IB14. This form can be obtained from the website of the Alabama State Employees' Insurance Board.
 
Alabama State Employee Plan Change Form IB14 Step 1: At the top of the form, check the box next to the type of coverage you are seeking to obtain, or indicate if you are declining coverage.
 
Alabama State Employee Plan Change Form IB14 Step 2: On the first line enter your name, sex and the date on which coverage took effect.
 
Alabama State Employee Plan Change Form IB14 Step 3: On the second line enter your contact telephone number and date of birth.
 
Alabama State Employee Plan Change Form IB14 Step 4: On the third line enter your street address.
 
Alabama State Employee Plan Change Form IB14 Step 5: On the fourth line enter your city, state and zip code.
 
Alabama State Employee Plan Change Form IB14 Step 6: On the fifth line enter your home and work telephone numbers, as well as your email address.
 
Alabama State Employee Plan Change Form IB14 Step 7: The next four blank lines are provided to document dependents you are seeking coverage for. This is only required for those seeking basic coverage (SEHIP). On the first line, enter your spouse's name, birthdate and Social Security number.
 
Alabama State Employee Plan Change Form IB14 Step 8: On the next three lines, enter the same information for your children. Indicate their relationship to you by circling the appropriate label in the second column. 
 
Alabama State Employee Plan Change Form IB14 Step 9: If you are applying for supplemental coverage or Southland optional policies for vision, dental or cancer care or hospital indemnity, you must complete the last section documenting your primary insurance coverage. The first question asks you if this primary coverage has a spousal carve-out. Indicate "Yes" or "No" by circling the applicable response.
 
Alabama State Employee Plan Change Form IB14 Step 10: Provide all identifying information required about your health insurance company, as well as any dental coverage you have.
 
Alabama State Employee Plan Change Form IB14 Step 11: Sign and date the form. Mail it to the address given at the bottom of the second page.
 

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Form CL-472 Request for Reimbursement Preferred Health FSA/HRA

Form CL-472 Request for Reimbursement  Preferred Health FSA/HRA

 

INSTRUCTIONS: ALABAMA REQUEST FOR REIMBURSEMENT PREFERRED HEALTH FSA/HRA (Form CL-472)

 

 

In Alabama, state employees enrolled with BlueCross BlueShield use a form CL-472 to request a reimbursement for eligible health services. This document can be obtained from the website maintained by BlueCross BlueShield of Alabama.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 1: The employee should enter their signature and the date at the top of the form where indicated.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 2: Section 1 concerns the employee. Your first name, middle initial and last name in the first three blank boxes.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 3: In the next three blank boxes, enter the month, date and year of your birth.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 4: Enter your preferred blue account number prefix in the next blank box.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 5: Enter your preferred blue account number contract number in the blank box.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 6: Enter your company name in the next blank box.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 7: Enter your work and home phone numbers in the next two blank boxes, including the area codes.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 8: Section 2 concerns the type of reimbursement being sought. Indicate whether the service was medical, vision, dental, orthodontics, RX/OTC or other by filling in the oval next to the appropriate statement.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 9: In the first two blank boxes, enter the patient's first and last names.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 10: Indicate whether the patient is self, your spouse or a dependent by filling in the appropriate oval.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 11: Indicate whether the patient is covered by insurance by filling in the appropriate oval.

 

Alabama Request For Reimbursement Preferred Health FSA/HRA CL-472 Step 12: Provide all other information requested about the patient. You may document up to five patients on one form. Provide the amount requested for reimbursement for each service and the total at the bottom of the page.

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