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Client ID Household ID Number First Contact Date Case Close Date: This form must be completed within 24 hours of intake. A. CLIENT DEMOGRAPHICS1. Name: 2. Mothers/Guardians Name: 3. Gender Identity:
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This form is a tax form.
Individuals and businesses that meet certain criteria.
You must provide accurate and complete information.
The purpose of this form is to report financial information to the tax authorities.
Income, expenses, deductions, etc.
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