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2017/2018 EMERGENCY HEALTH INFORMATION(Please use black or blue ink for copying purposes)(2 Sided Form See reverse side) Students Last Name Students First Name Students Address City Home Phone Date

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Please use black ink for filling out the form.

Who is required to file please use black or?

All taxpayers are required to file with black ink.

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The purpose is to ensure clarity and readability of the form.

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All relevant information related to tax filing must be reported in black ink.

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