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Get Form Approved TOE 120/420 OMB No. 0960-0009 MARRIAGE ...

OYED PERSON / / I am the spouse of the person named below, who has applied for insurance benefits under Title II of the Social Security Act, as presently amended. NAME OF SPOUSE (First Name) (Maiden Name, if applicable) (Last Name) 1. Indicate whether your present marriage was performed by: Clergyman or Authorized Public Official 2. Were you married before your present marriage? P R E V I O U S M A R R I A G E P R E V I O U S M A R R I A G E Other (Explain) u Yes (If ''yes'', give.

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