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Iowa 1040 Form
No.
Current mailing address (number and street, apartment, lot, or suite number) or PO Box
School District No.
•
•
You must answer these questions
Dependent children for whom an exemption is claimed in Step 3
How many have health care coverage?
_______
City, State, ZIP
(including Medicaid or hawk-i)
How many do not have health care coverage? _______
•
•
STEP 2: Filing Status: Mark one box only.
1
2
5
6
Single: Were you claimed as a dependent on another person’s Iowa return?
YES
NO...
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