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If completing by hand please use BLACK PEN P A T I E N T D E T A I L S INITIAL FIRST NAME ASSIGNMENT FORM SURNAME PATIENT REF. No. RESIDENTIAL ADDRESS EXPIRY DATE CHECKED ITEM NO. S/D BENEFIT ASSIGNED
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The db4e form is a tax form used to report certain information to the IRS.
Individuals or entities who meet certain criteria specified by the IRS are required to file the db4e form.
The db4e form can be filled out manually or electronically, following the instructions provided by the IRS.
The purpose of the db4e form is to report specific information to the IRS for tax compliance purposes.
The db4e form typically requires reporting of income, deductions, and other financial information.
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