Texas Health and Human Client’s Statement of Self ...
Texas Health and Human Services Commission Client’s Statement of Self -Employment Income Declaración de ingresos del negocio propio del cliente See Instructions on Page 2 /Vea las instrucciones en la página 2. Form H 1049 December 2001 1. Name of Person Hav ing Self -Employment Income Nombre de la persona que tiene ingresos de negocio propio ................
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