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Department of the Treasury Internal Revenue Service Form 11652 Questionnaire and Supporting Documentation Form 1040 Schedule C Profit or Loss from Business Rev. May 2005 Name Social security number Business Address Telephone Numbers Home Business Business Website if available 1. Please provide a description of your business. Type of work product sold service provided hours of operation where business is conducted 2. Did you receive Form s 1099 MISC for the income reported No Yes Please send...
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