№ files_lp_3_process_7_057220
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Federal government application form issued by the Pension Benefit Guaranty Corporation for requesting pension benefit payments as a beneficiary or alternate payee and for selecting payment and federal tax withholding options.
Year:
2020
Country:
United States
Organization:
Pension Benefit Guaranty Corporation
Form Number:
705
OMB Control Number:
1212-0055
OMB Expiration Date:
10/31/2021
Document Type:
Government benefits application form
Subject:
Pension benefit payments to beneficiaries or alternate payees
Intended Applicants:
Beneficiaries of deceased plan participants and alternate payees under a Qualified Domestic Relations Order
Payment Methods:
Electronic Direct Deposit (EDD), Electronic Transfer Account (ETA), paper check by mail
Taxation Section:
Federal income tax withholding election
Legal Reference:
Title 18, Section 1001, United States Code
Contact Address:
P.O. Box 151750, Alexandria, Virginia 22315-1750
Contact Phone:
1-800-400-7242
Price: 8 / 10 USD
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Organization:
Pension Benefit Guaranty Corporation
Form Number:
719
OMB Approval Number:
1212-0055
Date Printed:
12/14/2015
Type of Document:
Federal tax withholding election form
Subject:
Federal income tax withholding from pension payments
Applicable Year Reference:
2015
Issuing Authority:
Pension Benefit Guaranty Corporation
Contact Information:
PBGC Customer Contact Center 1-800-400-7242
Related Form:
IRS Form W-4P
Place of Issue:
Alexandria, Virginia
Year:
2015
Organization:
Pension Benefit Guaranty Corporation
Document Type:
Form / Information Collection
Region:
United States
Plan Name:
FX.PrismCase.CaseTitle.XF
Plan Number:
FX.PrismCase.CaseIdNmbr.XF
Date Printed:
12/14/2015
Date of Plan Termination:
FX.PrismCase.DOPT.XF
Target Audience:
Plan participants, beneficiaries, alternate payees
Required Proof:
Birth certificate, passport, marriage certificate, death certificate, QDRO
OMB Approval Number:
1212-0055
Expiration Date:
xx/xx/xx
Year:
2023
Region / City:
North America
Topic:
Compliance with EPA PFAS reporting rules
Document Type:
Guidance
Organization:
Association of Equipment Manufacturers (AEM)
Author:
Association of Equipment Manufacturers (AEM)
Target Audience:
Nonroad equipment manufacturers, suppliers, industry stakeholders
Effective Period:
Ongoing
Approval Date:
Not specified
Modification Date:
Not specified
Year:
Not specified
Jurisdiction:
Saint Kitts & Nevis
Document type:
Legal/Official Form
Subject:
Ship mortgage registration, transfer, and discharge
Governing law:
Saint Christopher & Nevis Merchant Shipping Act Cap. 7.05
Issuing authority:
Department of Maritime Affairs / International Registrar of Shipping and Seamen
Intended users:
Ship owners, mortgagees, transferees
Sections referenced:
Sections 77-83 of Section IV
Form requirements:
Typed or written in capital letters in black ink
Procedural notes:
Signature by ship owner or authorised officer, evidence of ownership if provisional registration, separate registration for multiple mortgages
Sanctions:
False statements may lead to deregistration and prosecution
Note:
Official seals and witness signatures required for execution
Year:
2020
Region / city:
North America
Topic:
Environmental Protection, Chemical Regulations
Document Type:
Best Practices
Organization:
Association of Equipment Manufacturers (AEM)
Author:
Association of Equipment Manufacturers (AEM)
Target Audience:
Equipment manufacturers, suppliers, and industry stakeholders
Period of Validity:
Indefinite, subject to updates
Approval Date:
Not specified
Date of Changes:
Ongoing updates as new EPA guidance is released
Year:
2024
Region / City:
Windhoek
Topic:
Legal profession, misconduct, disciplinary action
Document type:
Court Judgment
Institution:
High Court of Namibia
Author:
DE JAGER J
Target audience:
Legal professionals, court officials
Period of validity:
19 November 2024
Date of approval:
19 November 2024
Date of amendments:
N/A
Note:
Year
Theme:
Infrastructure, Business Planning
Document Type:
Project Proposal
Target Audience:
Stakeholders, Businesses, Project Beneficiaries
Year:
2022
Region / city:
United States
Topic:
Health care survey
Document type:
Supporting Statement
Agency / institution:
Centers for Medicare & Medicaid Services, Office of Minority Health
Author:
Centers for Medicare & Medicaid Services
Target audience:
Researchers, policymakers, healthcare professionals
Period of validity:
3 years
Approval date:
February 11, 2022
Date of changes:
N/A
Description:
Document outlines the methodology for collecting data on Medicare beneficiaries from minority populations using the Medicare Beneficiary Experiences with Care Survey (MBECS) system, including its development and application for a range of priority populations.
Year:
2023
Region / City:
United States
Theme:
Immigration
Document Type:
Instructional
Agency:
U.S. Citizenship and Immigration Services (USCIS)
Author:
U.S. Citizenship and Immigration Services (USCIS)
Target Audience:
Applicants for U.S. immigration
Effective Period:
Expires 07/31/2024
Approval Date:
07/20/2021
Date of Changes:
10/12/2023
Year:
2024
Region / City:
United States
Theme:
Medicare, Health Care, Survey
Document Type:
Report
Organization / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
William S. Long
Target Audience:
Policymakers, Healthcare Providers, Researchers
Effective Period:
2024-2025
Approval Date:
June 26, 2024
Modification Date:
N/A
Note:
Year
Note:
Year
Subject:
Beneficiary ownership declaration, company registration
Document Type:
Form
Authority / Institution:
Licensing Authority
Target Audience:
Legal entities, authorized signatories
Year:
2024
Organization:
Center for Health Care Strategies (CHCS)
Program:
Building State Capacity for Community-Informed Policymaking Learning and Action Series
Document type:
Request for Applications
Audience:
Medicaid programs in U.S. states, commonwealths, and territories
Key dates:
April 9, 2024 – RFA release; April 25, 2024 – Informational webinar; April 30, 2024 – Non-binding Expression of Interest; May 30, 2024 – Applications due
Project period:
July 2024 – August 2025
Purpose:
Support states in creating or strengthening Medicaid Beneficiary Advisory Councils aligned with CMS rules
Funding:
Regrants up to $25,000 available for community entities
Contacts:
Anna Spencer, CHCS senior program officer, [email protected]
Eligibility:
All U.S. states, commonwealths, and territories
Activities:
Landscape assessment, partnership with community entities, development of BAC action plans, capacity building, technical assistance
Year:
2023
Region / City:
United States
Subject:
Medicare coverage and patient payment responsibilities
Document type:
Patient notice
Organization / Institution:
American Medical Association
Author:
American Medical Association
Target audience:
Medicare patients
Effective period:
N/A
Approval date:
N/A
Modification date:
N/A
Note:
Year
Document Type:
Form
Organization / Institution:
World Health Organization
Target Audience:
Staff, Consultants, Interns
Note:
Year
Program name:
John R. Justice Student Loan Repayment Program
Document type:
Service agreement acknowledgment
Appendix:
Appendix D
Issuing body:
Bureau of Justice Assistance
Related agencies:
JRJ State Administering Agencies
Subject matter:
Student loan repayment benefits and service obligation
Intended audience:
Current JRJ beneficiaries with unfulfilled initial service obligation
Service obligation term:
Initial 3-year term
Fiscal year:
Current fiscal year at time of execution
Legal notes:
Tax obligations disclaimer
Referenced authority:
Internal Revenue Service
Signature required:
Yes
Date required:
Yes
Year:
1982
Region / City:
United States
Subject:
Social Security, Demographic Survey
Document Type:
Technical Description
Institution:
Social Security Administration
Author:
Office of Research, Statistics, and International Policy
Target Audience:
Researchers, Social Security Administration staff
Period of validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
1982
Region / City:
N/A
Subject:
Administrative data for the 1982 New Beneficiary Survey and its 1991 Followup
Document Type:
Codebook
Organization:
Social Security Administration
Author:
N/A
Target Audience:
Researchers, Analysts, Government Agencies
Validity Period:
N/A
Approval Date:
N/A
Modification Date:
N/A