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Print in BLACK ink only and DO NOT STAPLE. Select Here for Amended Return Select Here for Composite Return Vendor Code (For use by S corporations or Partnerships) Fiscal Year Beginning (MM/DD/YY) Fiscal Year Ending (MM/DD/YY) Select the appropriate boxes that apply, as of December 31, 2017. Age 62 through 64 Age 65 or Older Blind Yourself Spouse Department Use Only 0 0 0 If filing a fiscal year return enter the beginning and ending dates here. Yourself Spouse Yourself Spouse 100% D.
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