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THE JACK & JILL CHILDREN FOUNDATION Date received: REFERRAL FORM CHILD DETAILS CHILD NAME: ___DOB: ___/___/___ MALE ___ FEMALE ___ADDRESS: ___Encode : ___ MEDICAL HISTORY/DIAGNOSIS(PLEASE INCLUDE

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Form Jack and Jill is a hypothetical or illustrative tax form used for training or educational purposes, typically used to explain filing processes.

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Individuals or entities meeting specific criteria laid out in the instructions for the form, often related to income thresholds, deductions, or credits, are required to file.

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