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S earnings so we make a decision about your claim. You must complete this form promptly. If you have just started a new business within the last three months fill in and return the estimated self-employed income declaration at the end of this form. If we do not receive this form, with all the information we need, within one calendar month of the date you claimed will be cancelled or made unsuccessful. Your Benefit Reference Number: Date issued: Section 1- About You About your partner (in t.

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