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Get Information Bulletin #22. Annual Report -- Fy04 - In

Nue. Employee Name Employee Social Security Number Military Servicemember Spouse s Name Military Servicemember Spouse s Social Security Number Address where you both currently reside Street City State Zip Code Form WH-4MIL is to be used only for employees claiming exemption from Indiana s income tax withholding requirements because they meet the conditions set forth under the Servicemembers Civil Relief Act, as amended by the Military Spouses Residency Relief Act (P.L. 111-97). In order.

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