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Nder Prop. Treas. Reg. 1.125-2. The Dependent Care expenses listed above qualify for the federal child care credit, and I will not be eligible to claim the tax credit for any Dependent Care expenses submitted. I will include the Taxpayer Identification/Social Security number(s) of any Dependent Care service provider(s) listed above on my annual tax return(s) using Form 2441. I am responsible for any inappropriate use or disclosure of my information that occurs due to my selected method of transm.

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