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DOC1024 (Rev. 02/2009)DIVISION OF ADULT
INSTITUTIONS
POLICY AND
PROCEDURES DAI Policy #: 500.30.61-Page 1 of 3
Original Effective Date: New Effective Date:
02/10/14
02/16/18
Supersedes: 500.30.61
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5003061 page 1 is a part of the tax form for reporting income.
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