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Get It 2104 Form 2019

Itial Last name Permanent home address ( number and street or rural route ) City, village, or post office Your social security number Apartment number State (6/11) Single or Head of household Married Married, but withhold at higher single rate ZIP code Note: If married but legally separated, mark an X in the Single or Head of household box. Are you a resident of New York City? .......... Yes No Are you a resident of Yonkers?..................... Yes N.

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