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Information required by state law.
If you are self-employed, please list the name of the business. For occupation, please list your line of work. "Business Person" is not acceptable. Please enter the type of business instead. If you are retired, please enter "N/A" under Employer and "Retired" under Occupation. If you are a homemaker, please enter "N/A" under Employer and "Homemaker" under Occupation.
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