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Get and Sign 502inj Form 2019
Security Number
Spouse’s first name
Initial
Last name
Social Security Number
Street address
State
City or Town
ZIP code
• Is the address on your joint return different from the address shown above? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
No
• Check this box only if you are divorced or separated from the spouse with whom
you filed the joint return and you want your refund issued in your name only . . . . . . . . . . . . . . . . . . . . . ....
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