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Get OR 40X 2004-2024

T return Date of Birth (mm/dd/yyyy) Spouse s Date of Birth (mm/dd/yyyy) Current mailing address State City ZIP code Telephone number ( ) A. As Originally B. Net Change C. Reported or as Adjusted INCOME AND DEDUCTIONS (Please read instructions) 1. 2. 3. 4. 5. 6. (increase or decrease) Correct Amount (see specific inst.) (explain on the back) Income.

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