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S 1, 2, 3, and 4, including signature line on page 4. Answer all questions or write N/A. Self-Employed Individuals Complete Sections 1, 2, 3, 4, 5 and 6 and signature line on page 4. Answer all questions or write N/A. For Additional Information, refer to Publication 1854, How To Prepare a Collection Information Statement Include attachments if additional space is needed to respond completely to any question. Name on Internal Revenue Service (IRS) Account Social Security Number SSN on IRS.

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