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Get OR OR-PS 2020

Photocopy Taxpayer s first name Taxpayer s last name Spouse s first name Spouse s last name Tax year Letter ID Federal employer identification number (FEIN) Provider s facility name, if applicable Provider s first name Provider s last name Provider s Social Security number (SSN) Part 1: Dependents. Complete this section for care you provided to the dependents of the taxpayer during the tax year above. Third party payments are payments made from sources o.

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