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SERVICE CONTRACT PROVIDER CONTROLLING PERSON – PERSONAL INFORMATION FORM. This form must be completed by each controlling person as defined in Occupations Code, ... Requester's Driver License #:. DL State: IT IS UNLAWFUL FOR ANY PERSON TO KNOWINGLY OBTAIN OR DISCLOSE PERSONAL INFORMATION FROM DMV. RECORDS EXCEPT AS ... The PIR is due on the annual franchise tax report due date. The report must be completed and signed by an officer, director or other authorized person. ... type of information you wish to receive. ... If you are requesting driving record information, the subject will be the person you are requesting information on. Complete this form only if you want us to give information ... Fill in the name and address of the person or organization of where you want us to send the ... If not the patient, name of person signing form: 13. Authority to sign on behalf of patient: All items on this form have been completed and my questions ... WHO CAN USE THIS FORM? People with Medicare who want 1-800-MEDICARE to be able to share their personal information with people they choose. Other Party's Information – This person is a (check one):. Petitioner ... Put that information on the Attachment to Confidential Information, form FL All Family ... You may also experience difficulties with relationships or your sense of identity. Our page on experiences of BPD has more information on what it's like living ... 1. What is beneficial ownership information? A. 2. Why do companies have to report beneficial ownership information to the US Department of the Treasury?