U.s. treas form treas-irs-4-2001 file: pub 4 front (rev.8-01) font: helvetica reg. with oblq., bold, black return address (please print) complete reverse side and mail to the irs adc listed below to: internal revenue service area distribution...
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American citizens abroad (aca) the voice of americans overseas mr. gerald shields internal revenue service room 6129 1 constitution avenue, n.w. washington d.c. 20224 concerns: statement of foreign financial assets omb no. 1545-2195 form no: 8938...
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To the employer when this form should be completed you should always complete this form when the insured or covered dependent suffers an accidental injury that results in a covered loss. in the case of accidental death: the accidental death...
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Check one dentist's pre-treatment estimate dentist's statement of actual services 1. patient name 2. relationship to employee spouse self child last please submit claim to: dental claims p.o. box 69421 harrisburg, pa 17106-9416 other 3. sex m f 4....
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