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Page 1 of 2 David Simona, D.O. & Ryan Simona, D.O. 7510 North Beach Street Fort Worth, TX 76137 Phone: 8174981818 Fax: 8175813761 PRIVACY RELEASE & ACKNOWLEDGEMENT Patient Name Date of Birth Authorization
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David Simonak D is a form used for reporting certain financial transactions to the IRS.
Individuals or entities who engage in specific financial transactions are required to file David Simonak D.
David Simonak D can be filled out electronically or on paper, following the instructions provided by the IRS.
The purpose of David Simonak D is to report financial transactions that may be taxable.
David Simonak D requires reporting of the details of the financial transaction, including amounts and dates.
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