What is In accordance with all applicable Code Regulations governing the gross income and assets from all sources, I certify under penalty of perjury that I do/do not receive income from the sources listed below (please check all that apply): Form?
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Instructions for the form In accordance with all applicable Code Regulations governing the gross income and assets from all sources, I certify under penalty of perjury that I do/do not receive income from the sources listed below (please check all that apply):
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