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This form is used for submitting an application or complaint for an Independent Medical Review (IMR) in California. It is available in Armenian language.
This document is a form used for filing an Imr application/complaint in California. It is available in Chinese language.
This document is a form used for filing an Imr Application/Complaint in California. It is available in the Khmer language.
This form is used for filing an Independent Medical Review (IMR) application or complaint in California. It is available in Farsi language for individuals who prefer to communicate in Farsi.
This form is used for filing an Imr application or complaint in California. It is available in Korean language.
This Form is used for submitting an application or complaint related to independent medical review (IMR) in California. It is available in Vietnamese language.
This form is used for requesting relief from maintenance in the state of California.
This form is used for notifying the relevant authorities in California about the completion of construction. It ensures compliance with construction regulations and ensures that necessary inspections have been carried out.
This Form is used for reporting progress on projects funded by the Active Transportation Program in California.
This form is used for affirming the OPEB (Other Post-Employment Benefits) cost analysis report in the state of California. It helps analyze the costs associated with providing post-employment benefits to public employees.
This Form is used for authorizing address changes in California.
This form is used for requesting disbursement of retiree benefits from the California Employers' Retiree Benefit Trust.
This Form is used for certifying impairment of a Memorandum of Understanding (MOU) in California.
This form is used to certify an individual's Medicare status in the state of California. It is necessary for determining eligibility for certain healthcare benefits and services.
This document certifies the OPEB actuarial information in the state of California. It ensures the accuracy and validity of the actuarial calculations for Other Post-Employment Benefits (OPEB) provided to public employees in California.
This form is used for certifying compliance with OPEB funding policy and GASB OPEB standards reporting in the state of California.
This document is used in California to authorize the use of the Automated Clearing House (ACH) method for making electronic payments.
This Form is used for the election of optional membership for California National Guard members in the California Defense Mobilization Committee (DMC).
This Form is used for the distribution of funds from the Judges' Retirement System (JRS) Extended Service Incentive Program (ESIP) Required Minimum Distribution (RMD) in California.
This Form is used for employers in California to request an estimate for disability allowance for their employees.
This form is used for the First Tier Future Election Package in California. It provides information and instructions for future elections.
This document describes the circumstances under which someone in California may be ineligible for Medicare certification.