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MEDICAID PLANNING Questionnaires form is very important. Your accuracy and completeness in responding will help us represent you. CLIENT INFORMATION Name: Date: Address: City: State: Zip: Home Phone:
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This form is for reporting income and expenses from a business.
Anyone who operates a business or is self-employed.
You must list all income and expenses related to your business.
The purpose is to report your business income and expenses to the IRS for tax purposes.
You must report all income, expenses, and deductions related to your business.
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