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STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES NOTICE OF FORM CHANGE NO. 15-129 DATE 06/02/2015 TO: FROM: County Welfare Director Supply Clerk /
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Start by writing the date in the designated space. In this case, write "06/02/2015" or "June 2, 2015" depending on the preferred format.
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15129 date 0602 to is a specific form used for tax purposes.
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