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INT OR TYPE First names and initials of employee and spouse: Last name: Home address (number and street): Apt. no.: City and State: Zip Code: NYC Department or Employee Agency where employed: Name Change Address Change Spouse AMENDED RETURN TAXPAYER S EMAIL ADDRESS n Country (if not US) n n nn EMPLOYEE'S SOCIAL SECURITY NUMBER SPOUSE S SOCIAL SECURITY NUMBER Daytime telephone number: 1 - FILING STATUS A. n MARRIED FILING JOINTLY OR SURVIVING SPOUSE Note:.

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