Forms (090)
AGRICULTURE DEPARTMENT
Electric Transmission Specifications and Drawings . . .
34.5kV Through 69kV. FORM. 1998. 0-16-060841-
S/N 001-010-00132-4 -- $17.00
115kV Through 230kV. FORM. 1998. 0-16-060842-2
S/N 001-010-00133-2 -- $19.00
FEDERAL BUREAU OF INVESTIGATION
Applicant Fingerprint Card, Form FD-258. FORM. 1999. Designed
to be used by law enforcement agencies, officials of State and local
governments, United States government agencies, and officials of Federally
chartered or insuredbanks to obtain information on individuals through
the use of fingerprints. Contains 14 boxes for the inked impressions
of fingerprints as well as other information on the individual being
fingerprinted. Instructions on back of card.
S/N 027-001-00086-6 -- $19.00
GENERAL ACCOUNTING OFFICE
Public Voucher for Transportation Charges:
Standard Form 1113. FORM. 1987. 0-16-002840-X
S/N 020-000-00235-2 -- $31.00 (Out of Stock)
Standard Form 1113-A. FORM. 1986. 0-16-002841-8
S/N 020-000-00236-1 -- $27.50
GOVERNMENT PRINTING OFFICE
GPO's Competitive Bidding Processing Kit. KIT. 1985. Contains
information needed for prospective bidders and contractors wishing to
provide printing services to the United States Government Printing Office.
Also contains a Bidder's Mailing List Application, "How to Do Business
With the GPO", Contract Terms, Billing Instructions, and other information.
0-16-002860-4
S/N 021-000-00128-7 -- $22.00
HEALTH AND HUMAN SERVICES
FDA Form . . .
Drug Master File:
FDA Form 3316 (Red Polyethylene Folder). FORM. 1995. 0-16-061426-0
S/N 017-012-00394-0 -- $32.00
FDA Form 3316A (Blue Polyethylene Folder). FORM. 1995.
0-16-061427-9
S/N 017-012-00395-8 -- $32.00
New Drug Application:
Archival Copy (Blue Polyethylene Folder), FDA Form 2626.
FORM. 1984. 0-16-061424-4
S/N 017-012-00392-3 -- $32.00 (Out of Stock)
Chemistry Section (Red Paper Folder), FDA Form 2626A. FORM.
1989. 0-16-061423-6
S/N 017-012-00391-5 -- $37.50
Clinical Data Section (Tan Paper Folder), FDA Form 2626E.
FORM. 1986. 0-16-061419-8
S/N 017-012-00387-7 -- $37.50 (Out of Stock)
Field Submission Chemistry Section (Maroon Paper Folder), FDA
Form 2626H. FORM. 1986. 0-16-061417-1
S/N 017-012-00385-1 -- $37.50
Microbiology Section (White Paper Folder), FDA Form 2626D.
FORM. 1998. 0-16-061420-1
S/N 017-012-00388-5 -- $37.50
Pharmacokinetic Section (Orange Paper Folder), FDA Form 2626C.
FORM. 1986. 0-16-061421-X
S/N 017-012-00389-3 -- $37.50 (Out of Stock)
Pharmacology Section (Yellow Paper Folder), FDA Form 2626B.
FORM. 1986. 0-16-061422-8
S/N 017-012-00390-7 -- $37.50
Statistics Section (Green Paper Folder), FDA Form 2626F.
FORM. 1987. 0-16-061418-X
S/N 017-012-00386-9 -- $37.50
Notice of Claimed Investigational Exemption for a New Drug:
FDA Form 2675 (Red Polyethylene Folder). FORM. 1990. 0-16-061425-2
S/N 017-012-00393-1 -- $32.00
FDA Form 2675A (Green Paper Folder). FORM. 1998. 0-16-061415-5
S/N 017-012-00383-4 -- $37.50
FDA Form 2675B (Orange Paper Folder). FORM. 1998. 0-16-061416-3
S/N 017-012-00384-2 -- $37.50
International Certificate of Vaccination as Approved by the
World Health Organization (Except for Address of Vaccinator), November
1991. FOLDER. 1991. Meant to be kept with a citizen's passport.
Much of the text is in both English and French. The instructions
are in English only. This form is available at a special price of
$15.00per 100 copies when mailed to one address. 0-16-061387-6
S/N 017-001-00483-9 -- $1.25
Medicare Health Insurance Claim Form, Form HCFA 1500:
Continuous Computer Paper, One part. FORMS. 1990. 0-16-034550-2
S/N 017-060-00470-3 -- $95.00
Continuous Computer Paper, Two part. FORMS. 1991. 0-16-034551-0
S/N 017-060-00471-1 -- $78.00
Snap-out, 2 part. FORM. 1990. 0-16-034549-9
S/N 017-060-00469-0 -- $20.00
IMMIGRATION AND NATURALIZATION
Affidavit of Support Under Section 213A of the Act, Form I-864.
FORM. 2000. Intended to benefit the sponsored immigrant and any agency
of the Federal government, any agency of a State or local government,
or any private entity to which the sponsor has an obligation under the
affidavit of support to reimburse for benefits granted to the sponsored
immigrant.
S/N 027-002-00455-8 -- $95.00
Aircraft/Vessel Report, Form I-92. FORM. 1973. 0-16-003661-5
S/N 027-002-00124-9 -- $11.50 (Out of Stock)
Application for Naturalization, N-400. FORM. 2002. Issued with
perforations.
S/N 027-002-00498-1 -- $76.00 (Out of Stock)
Application to . . .
Extend/Change Nonimmigrant Status, Form I-539. FORM. 2001.
S/N 027-002-00492-2 -- $69.50
Preserve Residence for Naturalization Purposes, Form I-470.
FORM. 2003.
S/N 027-002-00506-6 -- $50.00
Arrival/Departure Record: Welcome to the United States, Form I-94.
FORM. 1986. Must be completed by all persons except United States citizens,
returning resident aliens, aliens with immigrant visas, and Canadian
citizens visiting or in transit. 0-16-003675-5
S/N 027-002-00318-7 -- $19.00 (Out of Stock)
Biographic Information, Form G-325A. FORM. 2004. Provides biographic
information on an alien.
S/N 027-002-00505-8 -- $52.00
Crewman's Landing Permit, Form I-95A and Form I-95B. FORM.
1984.
S/N 027-002-00485-0 -- $46.00
Employment Eligibility Verification, Form I-9. FORM. 1991.
Designed to be used by employers as a record of their basis for determining
eligibility of an employee to work in the United States. Issued with
perforations.
S/N 027-002-00417-5 -- $26.50
Instructions for Completing Petition for a Nonimmigrant Worker,
Form I-129. FORM. 2002. Designed for an employer to petition for
an alien to come to the United States temporarily to perform services
or labor, or to receive training as an H-1A, H-1B, H-2A, H-2B, H-3,
L-1, O-1, P-2, or Q nonimmigrant worker.
S/N 027-002-00490-6 -- $72.50
Medical Examination of Aliens Seeking Adjustment of Status, Form
I-693, September 1, 1987. FORM. 1987. Contains one page of instructions
and four double-sided copies of Form I-693 with carbon paper between
each copy. Purpose of form is to determine if the alien applicant has
certain health conditions which may need further follow-up. This information
is required in order for a proper evaluation to be made of the alien's
health status.
S/N 027-002-00495-7 -- $85.00
Petition for . . .
Alien Fiance(e), Form I-129F. FORM. 2001. Used by a citizen
or lawful permanent resident of the United States to establish the
intent to marry an alien fiance(e) within 90 days of the arrival of
the fiance(e) in the United States.
S/N 027-002-00487-6 -- $52.50
Alien Relative, Form I-130. FORM. 2002. Used by citizen or
lawful permanent resident of the United States to establish the relationship
of certain alien relatives who may wish to immigrate to the United
States.
S/N 027-002-00497-3 -- $55.50
Alien Worker, Form I-140. FORM. 2003.
S/N 027-002-00504-0 -- $63.00
Petition to Remove the Conditions on Residence, Form I-751.
FORM. 2002.
S/N 027-002-00480-9 -- $55.50
LABOR DEPARTMENT
Authorization for Examination and/or Treatment, Form CA-16.
FORM. 1997. Includes form, instructions, and information for physician.
0-16-061787-1
S/N 029-016-00181-6 -- $46.00 (Out of Stock)
Claim for:
Compensation by Parents, Brothers, Sisters, Grandparents or Grandchildren,
Form CA-5b. FORM. 1997. Includes form, instructions, and attending
physician's report. Issued with perforations. 0-16-061792-8
S/N 029-016-00186-7 -- $46.00 (Out of Stock)
Compensation, Form CA-7, and Attending Physician's Report, Form
CA-20. FORM. 1999.
S/N 029-016-00209-0 -- $40.00 (Out of Stock)
Federal Employee's Notice of Traumatic Injury and Claim for Continuation
of Pay/Compensation, Form CA-1. FORM. 1999. Issued with perforations.
S/N 029-016-00204-9 -- $45.00 (Out of Stock)
Health Insurance Claim Form, HCFA-1500 and OWCP-1500. FORM.
1992. 0-16-061781-2
S/N 029-016-00158-1 -- $47.50 (Out of Stock)
Leave Buy Back (LBB) Worksheet/Certification and Election, Form
CA-7b. FORM. 1996. Intended to accompany Form CA-7, Claim for Compensation,
when a Federal employee is claiming leave buy back. 0-16-061783-9
S/N 029-016-00174-3 -- $45.00
Notice of Occupational Disease and Claim for Compensation, Form
CA-2. FORM. 1997. Includes form and instructions. Issued with perforations.
0-16-061786-3
S/N 029-016-00180-8 -- $42.00
Notice of Recurrence, Form CA-2a. FORM. 2000. Documents need
for additional medical treatment after release from treatment for a
work-related injury. Includes form and instructions.
S/N 029-016-00210-3 -- $47.50
Payroll, Form WH-347. FORM. 2000.
S/N 029-005-00032-0 -- $28.00
OFFICE OF PERSONNEL MANAGEMENT
Optional Application for Federal Employment, Optional Form 612.
FORM. 1994. Includes form and instructions. States that "You may apply
for most jobs with a resume, this form, or another written format. If
your resume or application does not provide all the information requested
on this form and in the vacancy announcement, you may lose consideration
for a job." 0-16-061607-7
S/N 022-000-00216-3 -- $24.00
Request for Payroll Deductions for Labor Organization Dues, Standard
Form 1187. FORM. 1989. 0-16-003252-0
S/N 022-000-00210-4 -- $39.00
STATE DEPARTMENT
Application for United States Passport or Registration: How to
Apply for a United States Passport, Form DS-11. FORM. 2002. Purpose
is to establish citizenship, identity, and entitlement to issuance of
a United States passport. 0-16-067606-1
S/N 044-000-02568-0 -- $27.50
Application for United States Passport by Mail, Form DS-82.
FORM. 2002. 0-16-067640-1
S/N 044-000-02569-8 -- $26.00
TREASURY DEPARTMENT
Direct Deposit Sign-Up Form, Standard Form 1199A. FORM. 1987.
0-16-004589-4
S/N 048-000-00363-0 -- $17.00
Instructions for the above. FORM. 1996.
S/N 048-004-02368-7 -- $4.00 (Out of Stock)
North American Free Trade Agreement: Certificate of Origin, Customs
Form 434. FORM. 1993. 0-16-061956-4
S/N 048-002-00120-6 -- $24.00
Public Voucher for Purchase and Services Other Than Personal, Standard
Form 1034. FORM. 1987. 0-16-003249-0
S/N 022-000-00207-4 -- $12.00
A service of the U.S. Government Printing
Office.
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