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STATE OF CALIFORNIAHEALTH AND HUMAN SERVICES AGENCYEDMUND G. BROWN JR., GovernorDEPARTMENT OF DEVELOPMENTAL SERVICES 1600 NINTH STREET, Room 320, MS 38 SACRAMENTO, CA 95814 TTY 6542054 (For the Hearing

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TTY 654-2054 form is used for reporting certain financial information to the tax authorities.

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Any individual or entity that meets the criteria set by the tax authorities for filing this form.

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The purpose of the form is to ensure that accurate financial information is reported to the tax authorities.

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The form requires reporting of income, expenses, deductions, credits, and other relevant financial data.

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