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This form is for individual providers who are affiliated with the group:. Please note the providers primary practice address by indicating 1 in the first column of the applicable address. This should
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This form is for reporting income and expenses for tax purposes.
Individuals and businesses who have earned income during the tax year.
The form can be filled out manually or electronically, following the instructions provided by the tax authority.
The purpose of this form is to accurately report financial information to determine tax liabilities.
Income, expenses, deductions, and any other relevant financial information.
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