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Address
Dependent 1
Dependent 2
Dependent 3
Did you obtain Market Place (Obama Care) coverage at anytime in 2022?
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Spouse's Date of Birth
Area Code
Phone
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Dependent 1 DOB
Relationship
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Dependent 2 DOB
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Dependent 3 DOB
Relationship
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Do you Owe Taxes
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2021 Filing Status
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