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Get TRCF 1000 Tax Form R1 Pocono Mountain School District

LAIMANT INFORMATION Claimant's Name Spouse's Name Check here if spouse is deceased Claimant's Social Security Number Spouse's Social Security Number Name(s) of property owner(s) as shown on property tax bill/receipt if different than claimant Mailing Address City, State & Zip Code Claimant's Date of Birth Spouse's Date of Birth Daytime Telephone Number Municipality PART II - FILING STATUS 1. I certify that I am: (Check One Box Only) A. A Claimant, age 65 or older as of December 31.

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