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ODESSA/HCA BEHAVIORAL HEALTH CUSTOMER DATA Curtis form is for Children only.
SECTION Agency:Date of Transaction (MMDDYYYY):Member ID:Date of Birth (MMDDYYYY):RACE: (1Yes for all that apply; Blank
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What is this form is for?
This form is used for reporting income tax information to the government.
Who is required to file this form is for?
Individuals, businesses, and other entities who have income tax obligations are required to file this form.
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The form can be filled out manually or electronically, following the instructions provided by the tax authority.
What is the purpose of this form is for?
The purpose of this form is to ensure that taxpayers accurately report their income and pay the correct amount of tax.
What information must be reported on this form is for?
Income, deductions, credits, and other relevant tax information must be reported on this form.
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