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Get Az 140ptc

Itial 1 Last Name If a joint claim, Spouse s First Name and Middle Initial 1 Current Home Address - number and street, rural route 2 City, Town or Post Office 3 State Zip Code Enter your SSN(s). Last Name Apt. No. Daytime Phone (with area code) Your Date of Birth 79 M M D D Y Your Social Security No. Spouse s Social Security No. Home Phone (with area code) 94 REVENUE USE ONLY. DO NOT MARK IN THIS AREA. Y Y Y QUALIFICATIONS FOR CREDIT (Check the boxes that apply): 4 On December 31,.

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