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ORTHODONTICS Robert C. Sjursen Jr. D. D. S. S P E C I A L I S T I N O R T H O D O N T I C S A N D D E N T O FA C I A L O R T H O P E D I C S Registration and Health History for Adults ABOUT YOU Name I prefer to be called Age Sex Birthday Soc. Sec. Home address STREET CITY STATE ZIP Hm phone Wk phone Email Whom may we thank for referring you to this office Names of other family members treated by our office Employer Occupation Years Employer s address Spouse s name Soc. Sec. Birthdate Work...

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What is sjursen jr?

Sjursen Jr is a form used to report financial information for tax purposes.

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Individuals or entities with certain financial transactions are required to file sjursen jr.

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Sjursen Jr can be filled out online or by mail following the instructions provided by the tax authorities.

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The purpose of sjursen jr is to report financial information accurately for tax purposes.

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Sjursen Jr requires reporting of income, expenses, deductions, and other relevant financial information.