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Eligibility Attestation PHARMACY USE ONLY APPLICANT NAME DOB: Part 1. Participant Income Information I hereby attest that my current estimated annual income from wages additional income sources such
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What is i affirm and certify?
i affirm and certify is a form that requires an individual to confirm the accuracy of the information provided.
Who is required to file i affirm and certify?
Individuals who are required to submit certain documentation or declarations may be asked to file i affirm and certify.
How to fill out i affirm and certify?
To fill out i affirm and certify, one must carefully read the form and provide accurate information where required.
What is the purpose of i affirm and certify?
The purpose of i affirm and certify is to ensure that the information provided is truthful and accurate.
What information must be reported on i affirm and certify?
The information required on i affirm and certify may vary depending on the specific document or declaration being made.
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