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efta-efta01222625DOJ Data Set 9OtherF. 2120
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Unknown
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DOJ Data Set 9
Reference
efta-efta01222625
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0
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F. 2120
Multiple Support Declaration
OMB No. 1545-W74
(Rev. October 2018)
► Attach to Form 1040.
Department of the Treasury
Attachment
Internal Revenue Service
► Go to ynywars.goy/Form2120 for the latest information.
Sequence No. 114
Name(s) shown on return
Your social security number
During the calendar year
. the eligible persons listed below each paid over 10% of the support of:
Name of your qualifying relative
I have a signed statement from each eligible person waiving his or her right to claim this person as a dependent for any tax year that
began in the above calendar year.
Eligible person's name
Social security number
Address (number, street, apt. no., city, state, and ZIP code)
Eligible person's name
Sods security number
Address (number, street, apt. no., city, state, and ZIP code)
Eligible person's name
Soda security number
Address (number, street, apt. no., city, state, and ZIP code)
Eligible person's name
Somali security number
Address (number. Street, apt. no., city, state. and ZIP code)
Form 2120 (Rev. 10-2018)
EFTA01222625
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