Fillable A — Business Information B — Gross Receipts Received C ... - oregon

Description
Self-Employment Income Worksheet FHIAP Family Health Insurance Assistance Program Do not use this form if you submitted your most recent (current) federal tax return. Use this form ONLY if you have filed an extension on your federal tax return or your income has changed drastically in the last year. Your income must be reported on an IRS Schedule C. Please complete and send the following: Send monthly business...
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