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Get Mn Dor M1prx 2017

(mm/dd/yyyy) If a Joint Return, Spouse s First Name and Initial Spouse's Last Name Social Security Number Spouse s Date of Birth Current Home Address (Street, Apartment, Route) City Place an X in all that apply: Renter Homeowner State Nursing home or adult foster care resident ZIP Code For department use only. Do not write in this space. Effective interest date: Mobile home owner Place an X in this box if your income changed because of a federal adjustme.

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