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About you:
Name:
Date of birth (mm/dd/yyyy): Spouse's Date of birth (mm/dd/yyyy) :
Filing Status:
About your income:
Check here if you were covered at any time during the tax year by an employer-sponsored pension plan
Check here if your spouse was covered at any time during the tax year by an employer-sponsored pension plan
Your modified Adjusted Gross Income for this tax year: $ Tax Year:
Spouse's modified Adjusted Gross Income for this tax year, IF filing separately: $
Your total compensation for this tax year: $
Your spouse's comp: $
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· 69 Lancaster County Rd., Harvard, MA 01451 · (978) 456-7971 · Fax: (978) 456-7972
· E-mail: info@stillriverretire.com