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CONFIDENTIAL HEALTH HISTORY Patient Name: First Last Date of Birthdays dated you have or have you had any of the following diseases or conditions? Circle Yes or Noyes / Noyes / No Heart Surgery Fainting
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Do you have or is a form used to report information about financial accounts held outside of the United States by U.S. taxpayers.
U.S. taxpayers who have financial accounts in foreign countries are required to file do you have or.
Do you have or can be filled out electronically using the FinCEN website or by mailing a paper form to the IRS.
The purpose of do you have or is to combat tax evasion by ensuring that U.S. taxpayers accurately report their foreign financial accounts.
Information such as the account holder's name, account number, type of account, and maximum value of the account during the reporting period must be reported on do you have or.
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