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SPANISH VERSION WOMEN IS INTERAGENCY HIV STUDY OBSTETRIC, GYNECOLOGICAL & CONTRACEPTIVE HISTORY FORM 23 SECTION A: GENERAL INFORMATION A1. PARTICIPANT ID: ENTER NUMBER HERE ONLY IF ID LABEL IS NOT
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This form is a state-specific document used for reporting financial information.
Entities or individuals who meet certain criteria set by the state authority.
The form can be filled out electronically or manually, following the instructions provided by the state.
The purpose of this form is to provide the state with accurate financial information.
Information such as income, expenses, assets, and liabilities may need to be reported.
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