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PATIENT INFORMATION Patient Name Last First Middle AKA Address Zip Code City State Home Phone Cell Work Phone Home Fax Employer s Name Address SS - Email Address will not be shared with outside sources Preferred Method of Contact circle one Race Home Work Ethnicity Date of Birth or Email Preferred Language Marital Status M S D W other Primary Care Physician Specialist Currently Seeing Preferred Pharmacy Phone /or Location Sex M F How did you hear about us please be specific Emergency...
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What is home fax?
Home fax is a report that discloses certain information about a taxpayer's home.
Who is required to file home fax?
Homeowners are required to file home fax.
How to fill out home fax?
Home fax can be filled out online or by mail through the designated form provided by the tax authorities.
What is the purpose of home fax?
The purpose of home fax is to assess the value of a taxpayer's home for taxation purposes.
What information must be reported on home fax?
Information such as the property's address, property size, amenities, and recent sales in the area must be reported on home fax.
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