OMB No. 0730-0014 DEPENDENCY STATEMENT - PARENT …
be listed. If any income received includes funds for children, be sure to show the amount received for them. List income for parents and children separately. If any income received during the past 12 months was a lump-sum (one-time) payment, be sure to state this. Verification documents are required. SOURCE b. PRESENT VALUE c. PARENT'S EQUITY d.
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