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Tax Year Self-Employement Information
please fill in all fields that apply to you
Tax Payer   Spouse
Type of Business: Type of Business:
(please be specific e.g. if consultant in what field?   (please be specific e.g. if consultant in what field?
Business Address:   Business Address:
(if different from home)
Business Name: Business Name:
EIN Number: EIN Number:
(if applicable)   (if applicable)
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