Massachusetts Form B PDF Details

Are you a Massachusetts resident who needs to file taxes? If so, it's important that you understand what is required of you when submitting the proper documentation. The Massachusetts Department of Revenue requires that individuals and businesses fill out Form B in order to correctly report their taxable income within the state. In this article, we'll walk through everything needed for filing your Form B with ease— from understanding which documents are necessary to submitting your completed form properly. Whether you're a first-time filer or an experienced taxpayer just looking for clarification, our comprehensive guide will teach you all about why it’s important to submit your Mass taxes accurately and on time - so let’s get started!

QuestionAnswer
Form NameMassachusetts Form B
Form Length1 pages
Fillable?Yes
Fillable fields15
Avg. time to fill out3 min 15 sec
Other namesct_dental_form_ b massachusetts general hospital w 9 form

Form Preview Example

FORM B

R) MASSACHUSETTS

GENERAL HOSPITAL

IMAGING

3D Imaging Service

55 Fruit Street - Gray 267C

Boston, MA 02114

Telephone: (617) 724-3667

Fax: (617) 643-2992

Authorization for Release of CT Dental Images

Patient Name: ________________________________________________________

(print please)

Date of Birth: _________________________

Medical Record #: ______________________-

I hereby authorize Massachusetts General Hospital to furnish medical images from my image file.

NEW DENTISTS’S NAME: _______________________________________

DENTIST’S TELEPHONE#:_______________________________________

MAIL TO (CHECK ONE) D

PATIENT OR D

NEW DENTIST

MAILING ADDRESS:_______________________________________

_________________________________________

_________________________________________

Date of Study:__________

Simplant Version (Simplant Pro or Version 7 above)______________________________

Media Type: (CD or DICOM CD or Prints)______________________________________

Please call Lab at (617 724-3667) with FedEx or Credit Card # for Shipping

__________

_______________________________________

Date

Patient Signature

Please fax this form back to the 3D Imaging Lab at 617-643-2992, thank you.

Revised 5/16/11

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Massachusetts Form B empty spaces to complete

Enter the required data in the area Simplant Version Simplant Pro or, Media Type CD or DICOM CD or Prints, Please call Lab at with FedEx or, Date, Patient Signature, Please fax this form back to the D, and Revised.

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