EFTA01222625.pdf

F. 2120 (Rev. October 2018) Multiple Support Declaration OMB No. 1545-W74 ► 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