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You may be eligible for a larger tax refund!
The Earned Income Tax Credit (EITC) is a benefit for working people with low to moderate income.
To qualify, you must meet certain requirements and file a tax return, even if you do not owe any tax or are not required to file. EITC reduces the amount of tax you owe and may give you a refund.
A third of Americans qualifying for EITC are newly eligible.
► This form is available to print in PDF or Word format at the bottom of this page.
REPORT OF EXAMINATION AND EVALUATION
By a □ physician □ psychologist □ social worker □ other: _____________________________ (In compliance with K.S.A. 59-3064)
Attach additional sheets as necessary.
(1) Date/Location of examination:_______________ , at ______________
(2) Name of proposed ward/conservatee:__________________________
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