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Soc 2298  Form

Soc 2298 Form

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FORM FOR INSTRUCTIONS* Provider Self-Certification By completing this form you are acknowledging that the wages you receive for providing IHSS and/or WPCS services to the recipient named above will be excluded from your federal taxes. Under penalties of perjury I declare that I am a provider receiving payments under the who lives with me in the same home. Provider Signature Date of Signature RETURN COMPLETED FORM TO IHSS IRS Live-In Self-Certification P. All requested information must be...
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