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REPORT OF PHYSICIAN Ohio Public Employees Retirement System 277 East Town Street, Columbus, Ohio 4321546421800222PERS (7377) www.opers.org×DRAWS×Please complete this form in its entirety. Failure

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This form is an official document used for reporting specific information required by tax authorities or regulatory agencies, usually related to income, deductions, or other financial matters.

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Required information typically includes personal identification details, income sources, deductions, and any applicable credits that affect tax calculations.