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Jan Cornelius, D.D.S.PATIENT INFORMATION (CONFIDENTIAL)Date Patient name Nickname S.S. # Date of Birth Address Apt City State Zip How Long Driver's License# Height Weight Home Phone # Business Phone
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Jan Cornelius D is a form used by individuals to report their dividend income.
Any individual who has received dividend income during the tax year is required to file Jan Cornelius D.
Jan Cornelius D can be filled out by providing the required information about the dividend income received during the tax year.
The purpose of Jan Cornelius D is to report dividend income to the tax authorities.
The information that must be reported on Jan Cornelius D includes the amount of dividend income received and any taxes withheld.
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