(See instructions)
(See instructions)
How to Claim Your Withholding Exemptions
Nonresident aliens must skip lines 2 through 7. See instructions
4. Additional exemptions are allowed if: (a) you and/or your spouse are over the age of 65 and/or (b) if you and/or your spouse are legally blind. Check box(es) for additional exemptions:
I hereby declare that to the best of my knowledge the above statements are true
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