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The Commonwealth of Massachusetts Group Insurance Commission Vision Care Service Record (This form to be maintained by the providers' office) SECTION I PROVIDER/PATIENT SECTION Member Name: SECTION
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This form is to be used for reporting income tax information.
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What is the purpose of this form to be?
The purpose of this form is to report income, deductions, and credits to calculate tax liability.
What information must be reported on this form to be?
Information such as income sources, expenses, deductions, and credits must be reported on this form.
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