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Name is required on this line; Individual tax return form 1040 instructions; Use get form or simply click on the template preview to open it in the editor. Name of the dependent care provider address If the provider is your employer’s dependent care plan, a copy of the statement provided by your employer under the plan.
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This form is used for certification of the dependent care provider's name, address, and taxpayer identification number to report on form 2441, child and dependent care expenses. A recently printed letterhead or printed invoice that shows the provider’s name, address, and tin. Name (as shown on your income tax return). Once you fill it out, you can save it on.
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Name Of The Dependent Care Provider Address
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