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Get AZ ADOR 140PTC 2017

If amending claim for tax year 2017 Check box 82F if filing under extension 95 1 1 2 3 79 82F Your First Name and Middle Initial Last Name Spouse s First Name and Middle Initial (if a joint claim) Last Name Current Home Address - number and street, rural route City, Town or Post Office Enter your SSN(s). Apt. No. State ZIP Code Your Social Security Number Spouse s Social Security No. Daytime Phone (with area code) 94 REVENUE USE ONLY. DO NOT MARK IN THIS AREA. 88 Your Date of Bi.

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