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GROUP HOME, INSTITUTION CHILD PHYSICAL EXAMINATION HEALTH RECORD State Form 49964 (R2 / 414)Date of birth (month, day, year)Name of childAddress (number and street, city, state, and ZIP code)MEDICAL

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Individuals who are required to report certain information as per the guidelines set by the relevant authorities.

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What is 49964ai?

49964ai is a form used for reporting certain financial information to the appropriate tax authorities.

Who is required to file 49964ai?

Entities or individuals who meet specific criteria as determined by the tax authorities are required to file 49964ai.

How to fill out 49964ai?

49964ai can be filled out by providing the required financial information in the designated sections of the form.

What is the purpose of 49964ai?

The purpose of 49964ai is to ensure that relevant financial information is accurately reported to the tax authorities.

What information must be reported on 49964ai?

Information such as income, expenses, and other financial data must be reported on 49964ai.

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