Get IA DoR 54-130 2013
T amount will be calculated for you. To calculate your reimbursement, continue on the back. I have reviewed this claim and believe it is correct and complete. Sign Your signature (or legal representative) Here ( ) Spouse Signature Preparer s Signature Phone ALLOW 3 MONTHS FOR PROCESSING Date ( ) Daytime Phone Mail to: Rent Reimbursement, Iowa Department of Revenue PO Box 10459, Des Moines, IA 50306-0459 54-130a (09/11/13) Check on refund: 1-800-572-3944 Reimbursement Amount.
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