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Sign online button or tick the preview image of the blank. Web attestation of income, no documentation available i, (first name) (middle name) (last name) attest that my household’s projected annual income for the benefit year in which i will receive financial assistance for my health plan is $ (annual income) Centers for disease control and prevention. Here at sampletemplates.com, we have collected a variety of attestation sample forms that are very easy to edit should you decide to simply use our templates.
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