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Get CA DCSS 0095 2004-2024

Es No If you were living with your husband at the time you became pregnant and he was not impotent or sterile, then no further answers are required, sign below. If not, complete PART II after signing below. 6. Comments I declare under penalty of perjury that the information on this form is true to the best of my knowledge and belief. Date: (MM/DD/YYYY) Signature Executed at City County State Note: If you signed outside of the State of California, this form should be notarized. Page 2 of.

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