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AMIGA Health Alexia Brothers Behavioral Health Hospital Child and Adolescent Questionnaire Date: Child/Adolescent: SSN#: Date of Birth: Phone #: () MaleFemalePerson Completing Form: Relationship:
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Obtain the 180148 6010-064 child form. This form can be found on the official government website or can be obtained from a local government office.
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The 180148 6010-064 child and is a tax form used for reporting information about dependent children.
Parents or guardians who have dependent children are required to file the 180148 6010-064 child and form.
You can fill out the 180148 6010-064 child and form by providing the requested information about your dependent children.
The purpose of the 180148 6010-064 child and form is to report information about dependent children for tax purposes.
You must report information such as the name, age, and relationship to the taxpayer of each dependent child on the 180148 6010-064 child and form.
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