alea-institute/kl3m-data-sample-004-shuffled huggingface dataset:
J-1 Visa Waiver Program

Physician Employment Verification Form

Ø This form is not to be submitted with the waiver application, but is to be completed

and mailed to the DRA within the physician’s first week of practice.

Ø Include copies of the physician’s state medical license with this form if they were not

included / available at the time the J-1 Waiver Application was submitted. Also

include copies of I-94 renewals and approval notices with this document.

Ø If the physician will be providing services for the employer at different sites than the

office site listed below, please provide those addresses on a separate page and attach

to this form.

PHYSICIAN:

Name: (print or type)______________________________ Employment Start Date:_____________

I-612 Approval Date: ____________________ H-1(b) Approval Date: ____________________

Address: Home: ______________________________ Office: ___________________________

Street Street

______________________________ ___________________________

City/State/Zip City/State/Zip 

______________________________ ___________________________

Home Phone Work Phone

Physician’s E-mail Address: _______________________________________________________

I hereby certify that I, the undersigned, do provide primary health care services at the above stated address 

for a minimum of 40 hours per week or 160 hours per month. 

Physician’s Signature_______________________________________ Date:_________________

DRA J-1 Visa Waiver Program – Physician Employment Verification Form 

Effective: September 4, 2020 

22
DRA J-1 Visa Waiver Program – Physician Employment Verification Form 

Effective: September 4, 2020

EMPLOYER:

Name of Employer: _____________________________________________________________

 

Address: ______________________________ City/State/Zip: __________________________

County: _______________________________

 

 

Type of Medical Practice: _________________________________________________________ (Example: General Practice, Family Medicine, Pediatrics, etc.)

Point of Contact Name: ___________________________________________________________

Phone Number: ___________________________ Email: _______________________________

I do hereby certify that Doctor ______________________________________________ is employed by 

_______________________________________________________________________ and provides 40 

hours of direct patient care per week, or 160 hours per month, at the above stated address.

 

____________________________________________

Employer’s Signature

____________________________________________

Employer’s Printed Name

____________________________________________

Date
EXHIBIT 31.2



CERTIFICATION PURSUANT TO
SECTION 302 OF THE SARBANES OXLEY-ACT OF 2002



I, Rick Ivanovick, Chief Financial Officer of RecycleNet and subsidiaries, certify that:



1.I have reviewed this report on Form 10-QSB of RecycleNet and subsidiaries.



2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;



3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the small business issuer as of, and for, the periods presented in this report;



4.The small business issuers other certifying officers and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) for the small business issuer and have:



(a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the small business issuer, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;



(b)Evaluated the effectiveness of the small business issuers disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and



(c)Disclosed in this report any change in the small business issuers internal control over financial reporting that occurred during the small business issuers most recent fiscal quarter (the small business issuers fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the small business issuers internal control over financial reporting; and



5.The small business issuers other certifying officers and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the small business issuers auditors and the audit committee of the small business issuers board of directors (or persons performing the equivalent functions):



(a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the small business issuers ability to record, process, summarize and report financial information; and



(b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the small business issuers internal control over financial reporting.



|October 28, 2004 | /s/   Rick Ivanovick   
|---------------- | -----------------------
|                 | Rick Ivanovick         
|                 | Chief Financial Officer
U.S. Department of Justice

Office of Community Oriented Policing Services

 Fact Sheet www.cops.usdoj.gov

2020 Law Enforcement Mental Health 

and Wellness Act Program

Law Enforcement Mental Health and Wellness Act (LEMHWA) funds are used to improve the delivery of and access to 

mental health and wellness services for law enforcement through training and technical assistance, demonstration projects, and 

implementation of promising practices related to peer mentoring mental health and wellness programs. The 2020 LEMHWA 

program funded projects that develop knowledge, increase awareness of effective mental health and wellness strategies, increase 

the skills and abilities of law enforcement, and increase the number of law enforcement agencies and relevant stakeholders 

using peer mentoring programs.

COPS Office Law Enforcement 

Mental Health and Wellness Act Awards

The 2020 LEMHWA program funded projects 

related to the following topic areas:

LEMHWA Peer Support Implementation Projects

National Peer Support Program for Small and Rural 

Agencies

Invitational Application

The full listing of awarded projects is located on the COPS 

Office website at https://cops.usdoj.gov/lemhwa.

Funding Provisions

Provisions include the following:

In FY 2020, the COPS Office awarded $4.5 million 

under the LEMHWA program.

The LEMHWA solicitation was open to all public governmental agencies, for-profit and nonprofit organizations, 

institutions of higher education, community groups, and 

faith-based organizations. Proposals were responsive to 

the topic selected, improved the delivery of and access to 

mental health and wellness services for law enforcement, 

and significantly advanced peer mentoring mental health 

and wellness programs within law enforcement agencies 

across the country.

July 2020

Contact the COPS Office

For more information about the LEMHWA 

program, please call the COPS Office Response 

Center at 800-421-6770 or visit the COPS Office 

website at www.cops.usdoj.gov.
2

2020 Law Enforcement Mental Health and Wellness Act Program

WASHINGTON

OREGON

CALIFORNIA

NEVADA

UTAH

COLORADO

WYOMING

MONTANA

 NORTH

DAKOTA

SOUTH

DAKOTA

NEBRASKA

KANSAS

OKLAHOMA ARKANSAS

LOUISIANA

MISSOURI

IOWA

MINNESOTA

WISCONSIN

ILLINOIS

INDIANA

OHIO

MICHIGAN

KENTUCKY

TENNESSEE

ALABAMA MISSISSIPPI GEORGIA

VIRGINA

PENNSYLVANIA

NEW YORK CONNECTICUT

MAINE

SOUTH

CAROLINA

NORTH

CAROLINA

FLORIDA

TEXAS

ARIZONA NEW

MEXICO

IDAHO

VERMONT

NEW JERSEY

DELAWARE

WEST

VIRGINA

MASSACHUSETTS

WASHINGTON ,DC

NEW HAMPSHIRE

RHODE ISLAND

FY 20 LEMHWA Peer Support Implementation Project Map

Police department

Sheriff’s offi ce

State implementation

Regional implementation

Tribal

July 2020
FORM
OF
  Amendment
 to
the
 Supplemental
Executive Retirement Plan
 Participation
Agreement
  This Amendment to the
Supplemental Executive Retirement Plan Participation Agreement (the “Participation
Agreement”) is entered into as of December 16, 2008, by and between Polonia Bank
and (referred to as the “Bank ”), and [name] (the
“Participant”).
  WHEREAS,
the Participant and the Bank entered into the Participation Agreement effective
as of July 1, 2006; and
  WHEREAS,
the parties may amend the Participation Agreement by a signed
instrument;
  WHERAS,
the parties desire to amend the Participation Agreement to make a clarification
consistent with Section 409A of the Internal Revenue Code of 1986, as
amended.
  NOW, THEREFORE, in
consideration of the mutual covenants and agreements set forth herein and for
other good and valuable consideration, the receipt and sufficiency of which are
hereby acknowledged, the parties hereto agree to amend the Participation
Agreement as follows:
  1.  A
new paragraph (e) is added to the Section 7 to read as follows:
  “For
purposes of Sections 7(b) and 7(e) a termination of employment shall occur upon
the date the Participant incurs a “Separation from Service” (as such term is
defined for purposes of Section 409A of the Code)”
  IN WITNESS WHEREOF, the
parties have duly executed and delivered this Amendment to the Participation
Agreement, or have caused this Amendment to the Participation Agreement to be
duly executed and delivered in their name and on their behalf, as of the day and
year first above written.
  POLONIA
      BANKBy:Title:PARTICIPANTName
#### § 1150.11 How does subdividing or joining debts owed to the Endowment affect the Chairperson's compromise, suspension, or termination authority?

A debtor's liability arising from a particular transaction or contract will be considered as a single claim in determining whether the claim is one of not more than $100,000, excluding interest, for the purpose of compromise or suspension or termination of collection action. Such a claim may not be subdivided to avoid the monetary ceiling established by the Federal Claims Collection Act of 1966, as amended. Joining two or more claims in a demand upon a debtor for payment of more than $100,000 does not preclude compromise or suspension or termination of collection action with regard to any one claim not exceeding $100,000, excluding interest.
Date of 

report 

1[16,<) 

I Oct. ~ 

2 

2 

~ 

2 

I 

~ruutr nf tqt lilttitr~ itatrs 

NINETY-FIRST CONGRESS 

FIB.ST SESSION {Convened Jtnua.ry 3, 1969 

EXECUTIVE CALENDAR 

Prepared under the direction of FRANCIS R. V ALEO, Secretary of the Senate 

By GERALD A.. HACKETT, Executive Qerk 

Friday, October 3, 1969 

NOMINATIONS 

Calendar Message Name of nominee 

I 

Offic.e Predecessor 

No. No. 

DEPARTMENT OF 

JUSTICE 

ll28 ll20 !It'll,. 1 l ~tl'\1 nrc!, nf U P. : t tur•ll ~- for the Edwin L. :Miller, Jr. 

C:1liforuia I 

~ontlwrn cli~trict of I CaliforJH,J, for the tt>nu 

I uf ., Your~. 

629 693 Jack \". Richm-d!lon, of U.H. m:1r~hal for the dis- \'ancr W Collm-. 

Kans.1~. 

I 

i net of Kn.nsas for the 

term of 4 yen.rs. 

FEDERAL 1\lARl'l'I:\IE 

COMMISSION 

I Holen D. Bentley, of .\ Fedt>l"<tl ::>.Iamune Com- J ohu Harllec, rc- ll30 llU1 

Mur~ ln.nd. I mi,biouer for the remain- ,jgnmg. 

der of the term expiring 

Jut\() 30, 1970. 

CIVIL AERONAUTICS 

BOARD 

o:.n ().ill Secor D. Bro\vuc, of Ma~- I A m!Jml>cr of the Civil 

-.n.chu-.ett..,. I Al'rouuutic' Board for Johu H. Crooker, 

I the n•m.tllldt•J of tht• tcun Jr., re,igned. 

NATIONAL TRANSPOR- I l'"-Pll'ill~ l)('c. :n, 1974.. 

TATIO~ SAFETY BOARD I 

A member of the N u.tional 632 695 hubel A. Burge~b, of Ari- I I zonu.. I Tran-.portutJOn 8."\fety I 

Bonrd tor the term e'i:-

piring Dec. 31, 1974. 

37-022--69--No.SS 

ll ~ bOHIHI.MCNT PktN.TIHb OFfiCE 1969
#### §§ 406.131-406.139 [Reserved]
NOT FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

SHAYLA DUKE; DAVID DUKE, 

Plaintiffs-Appellants, 

 v. 

CLYDE SAIKI, in his personal and official 

capacity as former Director of Department 

of Human Services, State of Oregon; et al., 

Defendants-Appellees, 

and 

DEPARTMENT OF HUMAN SERVICES; 

et al., 

Defendants.

No. 20-35155 

D.C. No. 6:17-cv-00770-MK 

MEMORANDUM*

Appeal from the United States District Court

for the District of Oregon

Ann L. Aiken, District Judge, Presiding

Submitted November 8, 2021**

Before: CANBY, TASHIMA, and MILLER, Circuit Judges.

* This disposition is not appropriate for publication and is not precedent 

except as provided by Ninth Circuit Rule 36-3.

** The panel unanimously concludes this case is suitable for decision 

without oral argument. See Fed. R. App. P. 34(a)(2).

FILED

NOV 17 2021

MOLLY C. DWYER, CLERK

U.S. COURT OF APPEALS
 2 20-35155 

Shayla Duke appeals pro se from the district court’s judgment dismissing the 

Dukes’ action alleging federal claims arising out of the reduction or termination of 

government benefits. We have jurisdiction under 28 U.S.C. § 1291. We review 

for an abuse of discretion a dismissal for failure to comply with a court order. 

Pagtalunan v. Galaza, 291 F.3d 639, 640 (9th Cir. 2002). We affirm.

The district court did not abuse its discretion by dismissing the Dukes’

action after the Dukes failed to file a fourth amended complaint as ordered or 

inform the court of an affirmative choice not to amend. See id. at 640, 642-43 

(discussing factors to consider in determining whether to dismiss under Fed. R. 

Civ. P. 41(b) for failure to comply with a court order; this court may review the 

record independently to determine if the district court abused its discretion); see 

also Edwards v. Marin Park, Inc., 356 F.3d 1058, 1065 (9th Cir. 2004) (“The 

failure of the plaintiff eventually to respond to the court’s ultimatum—either by 

amending the complaint or by indicating to the court that it will not do so—is 

properly met with the sanction of a Rule 41(b) dismissal.”).

In light of our disposition, we do not consider Shayla Duke’s challenges to 

the district court’s interlocutory orders. See Al-Torki v. Kaempen, 78 F.3d 1381, 

1386 (9th Cir. 1996) (“[I]nterlocutory orders, generally appealable after final 

judgment, are not appealable after a dismissal for failure to prosecute, whether the 

failure to prosecute is purposeful or is a result of negligence or mistake.” (citation 
 3 20-35155 

and internal quotation marks omitted)).

We reject as meritless Shayla Duke’s contentions regarding the magistrate 

judge’s jurisdiction. See 28 U.S.C. § 636(b)(1).

We do not consider matters not specifically and distinctly raised and argued 

in the opening brief. See Padgett v. Wright, 587 F.3d 983, 985 n.2 (9th Cir. 2009).

Shayla Duke’s request for appellate counsel, set forth in her opening brief, is 

denied. 

All pending motions are denied. 

AFFIRMED.
#### § 8.5 Access for investigators.

Concessioners shall permit representatives of this Department and, when appropriate and authorized representatives of other Federal or State agencies, access to any of their places of employment for the purpose of examining pay rolls and other records and otherwise to ascertain the facts with respect to compliance with the regulations in this part and State labor laws. The report of any investigation concerning a violation of the regulations in this part shall be submitted to the superintendent of the national park involved.

[24 FR 11053, Dec. 30, 1959. Redesignated at 51 FR 24656, July 8, 1986]
§ 71.7 Entrance fees for single-visit permits. ( a ) Entrance fees for single-visit permits shall be selected by the National Park Service from within the range of fees listed below, provided that such fees are established in accordance with the following criteria: ( 1 ) The direct and indirect cost to the Government;
( 2 ) The benefit to the recipient;
( 3 ) The public policy or interest served;
( 4 ) The comparable recreation fees charged by other Federal and non-Federal public agencies within the service area of the management unit at which the fee is charged;
( 5 ) The economic and administrative feasibility of fee collection; and,
( 6 ) Other pertinent factors.
( b ) There shall be two types of single-visit entrance fees charged at Designated Entrance Fee Areas for those persons not covered by either Golden Eagle or Golden Age Passports. ( 1 ) The fee for a single-visit permit applicable to those persons entering by private, noncommercial vehicle shall be no more than $3 per vehicle. The single-visit permit shall admit the permittee and all persons accompanying him in said vehicle. The single-visit permit shall be valid only at the one Designated Entrance Fee Area for which it was purchased. “Accompanying,” for the purpose of this section, shall mean entering together with the permittee while being transported by the same private, noncommercial vehicle which the permittee occupies.
( 2 ) The fee for a single-visit permit applicable to those persons entering by any means other than private, noncommercial vehicle shall be no more than $1.50 per person and shall be valid at the one Designated Entrance Fee Area for which it is paid.
( c ) Any of the permits provided for in paragraphs (a) and (b) of this section shall be valid at the Designated Entrance Fee Area for which it was purchased during the same calendar day of purchase. In addition, at overnight use areas, the single-visit permit shall be valid as long as the permittee and those covered by his permit remain within the boundaries of the Designated Entrance Fee Area, beginning from the first day of entry until the day of departure; except that on the same day that the entrance fee is paid, the permittee and those covered by the permit may leave and reenter without payment of additional fees.
[39 FR 33217, Sept. 16, 1974, as amended at 41 FR 22563, June 4, 1976. Redesignated at 46 FR 34329, July 1, 1981, and correctly redesignated at 46 FR 43045, Aug. 26, 1981]
BEFORE THE FEDERAL ELECTION COMMISSION 

In the Matter of ) 

Kiley for Congress and Ronald Gravino 

in his official capacity as Treasurer; 

Anita Greenberg-Belli for Council; 

Friends of Cole for Council; Friends of 

Mike Glackin; Friends of Ross Licitra; 

Friends of Sue Kiley for Commissioner; 

Koch for Council; O’Scanlon for Senate; 

Owen Henry for Mayor; Scharfenberger 

for Assembly; Senator Kyrillos 

Committee (EPS Dismissal Report) 

) 

) 

) 

) 

) 

) 

) 

) 

) 

) 

) 

MUR 8051 

CERTIFICATION 

I, Vicktoria J. Allen, Deputy Secretary and Clerk of the Federal Election 

Commission, do hereby certify that on February 14, 2024, the Commission 

decided by a vote of 6-0 to take the following actions in MUR 8051: 

1. Dismiss the complaint consistent with the Commission’s 

prosecutorial discretion to determine the proper ordering of its 

priorities and use of agency resources. Heckler v. Chaney, 

470 U.S. 821, 831-32 (1985), as recommended in the EPS Dismissal 

Report dated February 2, 2024. 

2. Close the file. 

3. Send the appropriate letters. 

Commissioners Broussard, Cooksey, Dickerson, Lindenbaum, Trainor, and 

Weintraub voted affirmatively for the decision. 

 Attest: 

 February 15, 2024 

 

Date Vicktoria J. Allen 

Deputy Secretary of the Commission 

Vicktoria J Allen

Digitally signed by Vicktoria J 

Allen 

Date: 2024.02.15 13:12:06 

-05'00'

MUR805100058
Rank ID # Committee Amount

1 C00341396 MOVEON.ORG POLITICAL ACTION $4,185,207

2 C00401224 ACTBLUE $4,009,630

3 C00325993 DEFEND AMERICA PAC $2,480,718

4 C00305318 BLUE DOG POLITICAL ACTION COMMITTEE $1,776,317

5 C00460147 DEMOCRATIC NATIONAL COMMITTEE - TRAVEL OFFSET ACCOUNT $1,465,913

6 C00458588 SARAH PAC $1,328,855

7 C00370007 DEMOCRACY FOR AMERICA $1,277,694

8 C00271338 AMERIPAC: THE FUND FOR A GREATER AMERICA $1,256,965

9 C00325076 CAMPAIGN FOR WORKING FAMILIES $1,167,612

10 C00448696 SENATE CONSERVATIVES FUND $1,146,887

11 C00441501 CAMPAIGN FOR CHANGE $1,011,754

12 C00415752 BORDER HEALTH FEDERAL PAC $908,154

13 C00449280 FREE AND STRONG AMERICA PAC INC. $796,208

14 C00384701 EVERY REPUBLICAN IS CRUCIAL (ERICPAC) $749,165

15 C00266734 THE WESTERN WAY PAC $686,087

16 C00202861 THE SENATE VICTORY FUND PAC $674,643

17 C00412791 FORWARD TOGETHER PAC $654,956

18 C99002396 AMERICAN POLITICAL ACTION COMMITTEE $604,347

19 C00368431 SENATE MAJORITY FUND $531,963

20 C00458000 PROGRESSIVE CHANGE CAMPAIGN COMMITTEE $519,698

21 C00219220 THE NEW REPUBLICAN MAJORITY FUND $467,930

22 C00235655 BLUEGRASS COMMITTEE $457,648

23 C00239905 BUCKEYE PATRIOT POLITICAL ACTION COMMITTEE $455,448

24 C00364174 TOGETHER FOR OUR MAJORITY POLITICAL ACTION COMMITTEE (TOMPAC) $437,106

25 C00349233 NEW MILLENNIUM PAC $409,557

26 C00344788 ALL AMERICA PAC $405,977

27 C00250399 AUTOMOTIVE FREE INTERNATIONAL TRADE PAC $403,279

28 C00247403 NORPAC $397,275

29 C00406314 HALEYS PAC $391,610

30 C00003558 NATIONAL COMMITTEE FOR AN EFFECTIVE CONGRESS $388,149

31 C00385377 ROAD TO VICTORY POLITICAL ACTION COMMITTEE $300,047

32 C00450692 POET PAC $281,126

33 C00336743 ASIAN AMERICAN HOTEL OWNERS ASSOCIATION PAC (AAHOA PAC) $272,522

34 C00146886 OREGON SMITH FUND (FKA BOB SMITH FOR CONGRESS CMTE) $264,893

35 C00478024 STOP THIS INSANITY INC $258,903

36 C00487892 GOLD AND SILVER POLITICAL ACTION COMMITTEE - FEDERAL $254,953

37 C00451153 GRIDIRON-PAC $254,451

38 C00390674 FREEDOM FUND $246,554

39 C00365536 COMMITTEE FOR HISPANIC CAUSES/BUILDING OUR LEADERSHIP DIVERSITY PAC (CHC BOLD PAC) $234,650

40 C00230342 21ST CENTURY DEMOCRATS $234,278

41 C00362236 COMMITTEE FOR SOUTHWEST VIRGINIA $234,265

42 C00429787 UNITED FOR PROGRESS LEADERSHIP COMMITTEE $230,260

43 C00327395 SEARCHLIGHT LEADERSHIP FUND $226,057

44 C00386482 RIGHTMARCH.COM PAC INC $214,933

45 C00428052 MAJORITY COMMITTEE PAC--MC PAC $205,040

46 C00426809 MADISON PAC; THE $202,595

47 C00135541 TO PROTECT OUR HERITAGE PAC $197,575

48 C00410407 EDWARD JONES PAC $188,244

49 C00395723 ALSTON & BIRD PAC $185,959

50 C00117721 CONGRESSIONAL MAJORITY COMMITTEE $183,992

Top 50 NonConnected PACs by Cash On Hand

as of December 31, 2010

PAC Table 5d