AGENCY |
FORM # |
FORM NAME |
TYPE |
REVISED |
PIH
|
52836
|
HA BOARD RESOLUTION /COMPREHENSIVE PLAN /ANNUAL STATEMENT
|
Form Only
|
|
CMS
|
1561
|
HEALTH INSURANCE BENEFITS AGREEMENT
|
Form Only
|
Jul 01, 2001
|
CMS
|
370
|
HEALTH INSURANCE BENEFITS AGREEMENT - Ambulatory Surgical Center
|
Form Only
|
Apr 01, 2002
|
CMS
|
1561
A
|
HEALTH INSURANCE BENEFITS AGREEMENT RURAL HEALTH CLINIC
|
Form Only
|
Apr 01, 2002
|
CMS
|
CMS
1500
|
HEALTH INSURANCE CLAIM FORM (NEW)
|
Form Only
|
Aug 01, 2005
|
CMS
|
1515
E
|
HHA FUNCTION & CARE SUMMARY: MODULE E
|
Form Only
|
Jun 01, 1990
|
CMS
|
1515
A
|
HHA FUNCTIONAL ASSESSMENT INSTRUMENT: MODULE A
|
Form Only
|
Jun 01, 1990
|
CMS
|
1515
B
|
HHA FUNCTIONAL ASSESSMENT INSTRUMENT: MODULE B
|
Form Only
|
Jun 01, 1990
|
CMS
|
1515
C
|
HHA FUNCTIONAL ASSESSMENT MODULE C: HOME VISIT
|
Form Only
|
Jun 01, 1990
|
CMS
|
1515
D
|
HHA FUNCTIONAL ASSESSMENT PATIENT CARE: MODULE D
|
Form Only
|
Jun 01, 1990
|
CMS
|
1572
A
|
HHA SURVEY & DEFICIENCIES REPORT
|
Form Only
|
Aug 01, 1990
|
Pay.gov
|
Pay.gov
13
|
HHS DMCS Payment
|
Form Only
|
|
Pay.gov
|
Pay.gov
14
|
HHS HQ
|
Form Only
|
|
Pay.gov
|
Pay.gov
15
|
HHS SSC
|
Form Only
|
|
CMS
|
R296
|
HOME HEALTH ADVANCE BENEFICIARY NOTICE (1 PAGE) Eng/Span
|
Form Only
|
Jun 01, 2002
|
CMS
|
1728
|
HOME HEALTH AGENCY COST REPORT
|
Both Form and Instructions
|
Jun 01, 2001
|
OCPD
|
HUD
40107
A
|
HOME Match Report
|
Both Form and Instructions
|
Dec 01, 1994
|
CMS
|
287
|
HOME OFFICE COST STATEMENT
|
Both Form and Instructions
|
Sep 01, 2005
|
OCPD
|
HUD
40107
|
HOME Program; Annual Performance Report
|
Form Only
|
Nov 01, 1992
|
PIH
|
52825
A
|
HOPE IV Budget Part I: Summary
|
Both Form and Instructions
|
|
PIH
|
52775
|
HOPE VI Neighborhood Networks Plan Guide
|
Both Form and Instructions
|
|
PIH
|
52774
|
HOPE VI Relocation Plan
|
Both Form and Instructions
|
|
PIH
|
52800
|
HOPE VI Revitalization Application Checklist
|
Form Only
|
|
PIH
|
52860
A
|
HOPE VI Revitalization Application Data Form
|
Form Only
|
|
PIH
|
52797
|
HOPE VI Revitalization Leverage Resources
|
Form Only
|
|
PIH
|
52787
|
HOPE VI Revitalization Project Readiness Certification
|
Form Only
|
|
PIH
|
52785
|
HOPE VI Revitalization Resident Training and Public Meeting Certification
|
Form Only
|
|
CMS
|
1984
99
|
HOSPICE COST & DATA REPORT (R-249)
|
Form Only
|
Feb 01, 2005
|
CMS
|
417
|
HOSPICE REQUEST FOR CERTIFICATION IN MEDICARE
|
Both Form and Instructions
|
Apr 01, 1984
|
CMS
|
643
|
HOSPICE SURVEY & DEFICIENCIES REPORT
|
Form Only
|
Nov 01, 1994
|
OPE
|
-
|
HSI Application
|
Both Form and Instructions
|
|
SBA
|
SBA
2103
|
HUBZone Internet Application Form
|
Both Form and Instructions
|
|
OH
|
HUD
302
|
HUD Manufactured Home Monthly Production Report
|
Form Only
|
Jan 01, 2000
|
OH
|
HUD
2457
|
HUD Survey Instructions and Report
|
Form Only
|
Aug 01, 2003
|
OA
|
HUD
9887
|
HUD-9887 & HUD-9887-A: Document Package For Applicant's/Tenant's Consent
|
Both Form and Instructions
|
May 31, 2003
|
OA
|
HUD
9887
A
|
HUD-9887-A & HUD-9887: Notice And Consent for the Release of Information to HUD and Public Housing Agency
|
Both Form and Instructions
|
May 31, 2003
|
OH
|
90166
CA
|
HUD/VA Addendum to Uniform Residential Loan Application
|
Form Only
|
|
OH
|
90167
CA
|
HUD/VA Addendum to Uniform Residential Loan Application
|
Form Only
|
|
BCBP
|
CBP
350
|
Harbor Maintenance Fee Amended Quarterly Summary Report
|
Both Form and Instructions
|
|
BCBP
|
CBP
349
|
Harbor Maintenance Fee Quarterly Summary Report
|
Both Form and Instructions
|
|
PHMSA
|
DOT F
5800.1
|
Hazardous Materials Incident Report
|
Both Form and Instructions
|
Jan 01, 2004
|
FRA
|
FRA-F
6180.110
|
Hazardous Materials Violation Report Form
|
Form Only
|
|
CDC
|
Appendix D and Appendix E
|
Heads Up: Concussions in High School Sports
|
Both Form and Instructions
|
|
MSHA
|
MSHA
5000
41
|
Health Activity Certification or Hoisting Engineers Qualification Request Form (30 CFR 75.100 and 77.100)
|
Instructions Only
|
|
MSHA
|
MSHA
5000
41
|
Health Activity Certification or Hoisting Engineers Qualification Request Form (30 CFR 75.100 and 77.100)
|
Form Only
|
|
OPM
|
SF-
2809
|
Health Benefits Election Form
|
Form Only
|
|
OPM
|
OPM
2809
|
Health Benefits Registration Form For Use Only by Annuitants and Former Spouses of Annuitants
|
Both Form and Instructions
|
|
VHA
|
10
10EZR
|
Health Benefits Renewal Form
|
Both Form and Instructions
|
|
FCC
|
FCC Form
467
|
Health Care Providers Universal Service, Connection Certification
|
Both Form and Instructions
|
|
FCC
|
FCC Form
465
|
Health Care Providers Universal Service, Description of Services Requested & Certification Form
|
Both Form and Instructions
|
|
FCC
|
FCC Form
466
|
Health Care Providers Universal Service, Funding Request and Certification Form
|
Both Form and Instructions
|
|
FCC
|
FCC Form
466
-A
|
Health Care Providers Universal Service, Internet Service Funding Request and Certification Form
|
Both Form and Instructions
|
|
IRS
|
8885
|
Health Coverage Tax Credit
|
Both Form and Instructions
|
|
IRS
|
1099
H
|
Health Coverage Tax Credit (HCTC) Advance Payments
|
Both Form and Instructions
|
|
HRSA
|
HRSA
502-1
|
Health Education Assistance Loan (HEAL)
|
Both Form and Instructions
|
|
HHS
|
HRSA
504
|
Health Education Assistance Loan (HEAL) Program
|
Both Form and Instructions
|
Aug 31, 2006
|
HRSA
|
HRSA
504
|
Health Education Assistance Loan(HEAL) Program: Forms
|
Both Form and Instructions
|
|
CMS
|
576
A
|
Health Insurance Benefits Agreement with OPO
|
Form Only
|
Jun 29, 2006
|
CMS
|
383
|
Health Insurance Case Summary
|
Form Only
|
Dec 01, 1982
|
ESA
|
OWCP
1500
|
Health Insurance Claim Form
|
Both Form and Instructions
|
May 01, 2003
|
HRSA
|
HRSA
519
|
Health Professions Nursing Student Loan Programs-Forms
|
Both Form and Instructions
|
|
USCIS
|
I-643
|
Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status
|
Both Form and Instructions
|
|
IRS
|
2290
|
Heavy Highway Vehicle Use Tax Return
|
Form Only
|
|
NOAA
|
1330-00-6044
|
High Seas Fishing Log
|
Instructions Only
|
|
NOAA
|
1330-00-6042
|
High Seas Mothership Log
|
Instructions Only
|
|
NOAA
|
1330-00-6042
|
High Seas Mothership Log
|
Form Only
|
|
NOAA
|
1330-00-6039
|
High Seas Pelagic Longline Gillnet Log
|
Instructions Only
|
|
NOAA
|
1330-00-6039
|
High Seas Pelagic Longline Gillnet Log
|
Form Only
|
|
NOAA
|
1330-00-6043
|
High Seas Purse Seine Log
|
Instructions Only
|
|
NOAA
|
1330-00-6043
|
High Seas Purse Seine Log
|
Form Only
|
|
NOAA
|
1330-00-6040
|
High Seas Trapsetter Log
|
Instructions Only
|
|
NOAA
|
1330-00-6040
|
High Seas Trapsetter Log
|
Form Only
|
|
NOAA
|
1330-00-6041
|
High Seas Trawl Log
|
Instructions Only
|
|
NOAA
|
1330-00-6041
|
High Seas Trawl Log
|
Form Only
|
|
NOAA
|
1330-00-6038
|
High Seas Troll/Pole and Line Log
|
Instructions Only
|
|
NOAA
|
1330-00-6038
|
High Seas Troll/Pole and Line Log
|
Form Only
|
|
IRS
|
553
|
Highlights of 2003 Tax Changes
|
Instructions Only
|
|
IRS
|
3991
|
Highlights of the Job Creation and Worker Assistance Act of 2002
|
Instructions Only
|
|
NOAA
|
1330-00-6053
|
Highly Migratory Species Observer Notification Requirements
|
Form Only
|
|
NOAA
|
1330-00-6034
|
Highly Migratory Species Observer Notification Requirements
|
Form Only
|
|
NHTSA
|
HS Form-
217
|
Highway Safety Program Cost Summary
|
Both Form and Instructions
|
|
FRA
|
FRA F
6180.57
|
Highway-Rail Grade Crossing Accident/Incident Report
|
Both Form and Instructions
|
|
FRA
|
FRA-F
6180.83
|
Highway-Rail Grade Crossing Warning System Activation Failure Report
|
Form Only
|
|
NPS
|
10-168, 10-168
A/B/C
|
Historic Preservation Certification
|
Both Form and Instructions
|
|
NPS
|
1443-00-0026
|
Historic Preservation Fund Grants to Tribes
|
Both Form and Instructions
|
|
PD&R
|
HUD
40076
HBCU
|
Historically Black Colleges and Universities (HBCUs)Grants Program Application
|
Form Only
|
Apr 01, 2003
|
IRS
|
936
|
Home Mortgage Interest Deduction
|
Instructions Only
|
|
OCPD
|
HUD
40096
|
Homebuyer/Homeowner Rehab Completion Report
|
Both Form and Instructions
|
Feb 01, 2003
|
OCPD
|
HUD
40094
|
Homeownership Assistance/Rental Housing Project Set-Up Report; Home Program Cash and Management Information System
|
Both Form and Instructions
|
Feb 01, 2003
|
OH
|
52756
|
Homeownership Counseling Certification
|
Form Only
|
|
ESA
|
WH
75
English
|
Homeworker Handbook
|
Form Only
|
Nov 01, 1988
|
ESA
|
WH
75
ESPANOL
|
Homeworker Handbook (Spanish - Manuel de Empleado Casero)
|
Form Only
|
Nov 01, 1988
|
CNCS
|
None
|
Honor Roll Application
|
Form Only
|
|
FRA
|
FRA-F
6180.3
|
Hours of Service Report - Railroads
|
Form Only
|
Feb 01, 1972
|
IRS
|
926
|
Household Employer's Tax Guide
|
Instructions Only
|
|
IRS
|
1040
SCH H (PR)
|
Household Employment Tax (Puerto Rican version)
|
Form Only
|
|
IRS
|
1040
SCH H
|
Household Employment Taxes
|
Both Form and Instructions
|
|
HUD
|
52641
|
Housing Assistance Payments Contract Section 8 Tenant-Based Assistance Housing Choice Voucher Program
|
Both Form and Instructions
|
|
PIH
|
52651
|
Housing Choice Voucher (HCV) Family Self-Sufficiency (FSS) Program Coordinator Funding
|
Form Only
|
|
HUD
|
52517
|
Housing Choice Voucher Program Request for Tenancy Approval
|
Form Only
|
Jun 01, 2003
|
OH
|
646
|
Housing Consultant's Certificate
|
Form Only
|
|
OH
|
HUD
9902
|
Housing Counseling Agency Fiscal Year Activity Report
|
Both Form and Instructions
|
Oct 31, 2002
|
OH
|
HUD
9908
|
Housing Counseling Client Survey
|
Form Only
|
Mar 31, 2002
|
OCPD
|
HUD
40110
B
|
Housing Opportunities for Persons with AIDS (HOPWA)
|
Both Form and Instructions
|
Apr 01, 2004
|
PIH
|
52670
|
Housing Owner's Certification and Application for Housing Assistance Payments
|
Form Only
|
|
ESA
|
WH
521
|
Housing Terms and Conditions
|
Form Only
|
Mar 01, 1999
|
FS
|
FS
1300-5
|
How Are We Doing Customer Service Comment Card
|
Form Only
|
|
IRS
|
919
|
How Do I Adjust My Tax Withholding?
|
Instructions Only
|
|
IRS
|
946
|
How To Depreciate Property
|
Instructions Only
|
|
IRS
|
579
(SP)
|
How to Prepare the Federal Tax Return
|
Instructions Only
|
|
MMS
|
MMS
132
|
Hurricane and Tropical Storm Evacuation and Production Curtailment Statistics - Gulf of Mexico OCS Region (GOMR)
|
Form Only
|
|