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Get GA 500EZ 2022-2024

) P ag e 1 SPOUSE S SSN# STATE ISSUED YOUR DRIVER S LICENSE/STATE ID YOUR FIRST NAME MI LAST NAME (For Name Change See IT-511 Tax Booklet) SUFFIX SPOUSE S FIRST NAME MI LAST NAME SUFFIX ADDRESS (NUMBER AND STREET or P.O. BOX) (Use 2nd address line for Apt, Suite or Building Number) CHECK IF ADDRESS CHANGED DEPARTMENT USE ONLY CITY (Please insert a space if the city has multiple names) STATE ZIP CODE (COUNTRY IF FOREIGN) Use Federal Adjusted Gross Income, NOT Federal Taxabl.

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