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Dependents (see instructions): (2) Social security number (3) Relationship to you (4) check if qualifies for (see inst.): (1) First name Last name Child tax

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Dependents (see instructions): (2) Social security number (3) Relationship to you (4) check if qualifies for (see inst.): (1) First name Last name Child tax credit Credit for other dependents Alyssa Schmitz 824-84-8456 Daughter X Tyler Schmitz 824-34-9584 Son X Connor Schmitz 824-56-2984 Son X

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