№ files_lp_4_process_2_64143
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Administrative affirmation form used within the Wisconsin Medicaid and BadgerCare Plus 1915(i) Housing Support Benefit documenting a member’s acknowledgment of receiving information about abuse, neglect, exploitation, and county reporting contacts for Adult Protective Services.
Year:
2025
State:
Wisconsin
Country:
United States
Subject:
Medicaid housing support services and health and welfare affirmation
Document Type:
Affirmation form
Agency:
Wisconsin Department of Health Services
Division:
Division of Medicaid Services
Legal Reference:
2019 Wisconsin Act 76; Amended Wis. Stat. § 16.308
Program:
Wisconsin Medicaid and BadgerCare Plus 1915(i) Housing Support Benefit
Form Number:
F-03278
Purpose:
Acknowledgment of receipt of information regarding abuse, neglect, and exploitation and county contacts for Adult Protective Services
Target Audience:
Members receiving Housing Support Services under the 1915(i) Medicaid Housing Support Benefit
Related Services:
Housing Consultation service; Adult Protective Services
Required Action:
Member signature confirming receipt of information
Recordkeeping Requirement:
Completed form stored in the member’s record
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Note:
Year
Document Type:
Assessment
Document type:
Application form
Purpose:
Referee affirmation and evidence verification for teacher certification
Application stage:
Stage 1
Education sector:
School education
Professional standards:
Australian Professional Standards for Teachers
Governing body:
Teacher certification authority
Intended users:
Certification applicants, referees, principals or supervisors
Geographic context:
Australia
Signature requirements:
Applicant, referees, principal or delegate
Content scope:
Referee affirmation, evidence verification, professional standards descriptors
Administrative process:
Teacher certification assessment
Year:
2024
Region / City:
Louisiana
Subject:
Health License, Medical Ethics, Professional Conduct
Document Type:
Legal Form
Organization / Institution:
Louisiana State Board of Medical Examiners
Author:
Louisiana State Board of Medical Examiners
Target Audience:
Medical professionals seeking licensure in Louisiana
Validity Period:
Ongoing, as per licensing requirements
Approval Date:
June 13, 2024
Modification Date:
N/A
Year:
2024
Region / City:
Louisiana
Topic:
Medical Licensure
Document Type:
Affidavit
Organization / Institution:
Louisiana State Board of Medical Examiners
Author:
Louisiana State Board of Medical Examiners
Target Audience:
Physicians, Podiatrists
Period of Validity:
N/A
Approval Date:
N/A
Date of Amendments:
N/A
Document type:
Affirmation letter
Program:
Registered Strength and Conditioning Coach (RSCC)
Organization:
National Strength and Conditioning Association
Purpose:
Verification of full-time strength and conditioning employment and experience
Employment status:
Full-time
Professional role:
Strength and conditioning coach
Applicable sectors:
Professional sports, collegiate sports, high school sports, tactical training units
Credential references:
CSCS, CSCCA, ASCA, UKSCA
Required attachments:
Statement of work, updated resume, formal job description
Signatories:
Candidate, supervisor or program administrator
Verification criteria:
Program definition of full-time status
Contact information required:
Yes
Year:
2026
Region / City:
United States
Subject:
Education
Document Type:
Agreement
Organization / Institution:
Local Educational Agency (LEA)
Author:
Not specified
Target Audience:
Nonpublic school officials, public school officials
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Jurisdiction:
Family Court of the State of New York
County:
[Specified County]
Legal Basis:
FCA § 413(3)(d); Article 5-B
Form Number:
Form 4-20a
Related Form:
Form 4-5/5-1-d (Confidential Information Form)
Subject Matter:
Motion to Vacate Adjusted Order of Support
Parties:
Petitioner and Respondent
Proceeding Type:
Support Proceeding
Grounds Stated:
Lack of personal jurisdiction due to improper service
Relief Requested:
Vacatur of adjusted order of support
Declaration:
Affirmation under penalties of perjury under the laws of New York
Date of Form:
4/2025
Year:
1995
Region / City:
Moravian Church in America
Topic:
Baptism and Confirmation Rituals
Document Type:
Worship Guide
Organization / Institution:
Moravian Church in America
Author:
Interprovincial Board of Communication
Target Audience:
Church Congregations, Baptism and Confirmation Candidates
Effective Period:
N/A
Approval Date:
1995
Date of Changes:
N/A
Year:
2000
Region / City:
Dominican Republic
Document Type:
Worship Service
Organization / Institution:
Church or Religious Group
Author:
Leader, Community Members
Target Audience:
Faith Communities, Women’s Rights Activists
Period of Validity:
25 November (International Day for the Elimination of Violence Against Women)
Approval Date:
2000
Date of Changes:
None
Year:
2026
Region / City:
Louisiana
Topic:
Medical Licensing, Dispensing Regulations
Document Type:
Legal / Regulatory Form
Institution:
Louisiana State Board of Medical Examiners
Author:
Louisiana State Board of Medical Examiners
Target Audience:
Medical professionals applying for licensure in Louisiana
Period of Validity:
Ongoing until revocation or renewal
Date of Approval:
Not specified
Date of Amendments:
Not specified
Year:
2026
Region / City:
Warkworth, New Zealand
Subject:
Legal affidavit / affirmation under Common Law
Document Type:
Court form
Institution:
New Zealand Common Law Court of Justice
Author:
Not specified
Target Audience:
Parties to legal proceedings
Case Number:
Not specified
Filing Requirements:
Identification of plaintiff/applicant and defendant/respondent, evidence numbering, exhibits attachment
Authorized Officers:
Clerk, Judge, Magistrate, Justice of the Peace, Notary Public, Commissioned Officer, Minister of Religion, Overseas representative
Year:
2026
Jurisdiction:
Georgia, United States
Document Type:
Legal/Administrative Form
Subject:
Law Enforcement, Arrest Records, Booking Photographs
Issuing Authority:
Georgia State Law Enforcement Agency
Relevant Law:
OCGA §35-1-19, Code Section 50-18-77, Titles 16 and 40
Intended Users:
Individuals requesting booking photographs
Requirements:
Affirmation statement for lawful use of booking photographs
Restrictions:
Prohibition on posting or publishing booking photographs without compliance
Date of Issue:
2026
Year:
2025
Region / City:
Brooklyn
Theme:
Church Service Schedule and Events
Document Type:
Church Bulletin
Organization:
Brooklyn Community United Methodist Church
Author:
Pastor Jinkyoung You
Target Audience:
Congregation
Event Date:
September 7, 2025
Date of Last Update:
September 7, 2025
Note:
Contact Information
Email:
[email protected]
Phone:
608-455-3344
Website:
brooklynumc.org
Year:
2023
Region / City:
New York City
Subject:
Contractor Qualifications and Tax Compliance
Document Type:
Affirmation Statement
Organization / Institution:
City of New York
Author:
City of New York
Target Audience:
Contractors, Bidders
Period of Validity:
N/A
Date of Approval:
N/A
Date of Amendments:
N/A
Note:
Year
Subject:
Gender Affirmation
Document type:
Template