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3648 Seneca Street West Seneca, NY 142243400 T: (716) 7711354 F: (716) 7711562 PHYSICIAN/HEALTH CARE PROVIDER REFERRAL FORM 1 of 1 Patient Information Patient Name: Date of Birth: Gender: Male Female
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The acronym stands for Statement of Specified Foreign Financial Assets.
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U.S. taxpayers who meet the filing threshold are required to file s s w s.
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Information such as the type and value of foreign financial assets must be reported.
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