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CFS
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Idaho State tax CommISSIon
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EFO00122
08-23-10
ComPRehenSIVe FInanCIaL Statement
SECTION 1. PERSONAL INFORMATION
Your first name
MI
Last name
Your Social Security number
Your date of birth
Other names and aliases used
Spouse’s first name
MI
Last name
Spouse’s Social Security number
Spouse’s date of birth
Spouse’s other names and aliases used
Number of dependents living with you
Dependent ages
Your current physical address
City
State
Zip Code
Home telephone number
Your mailing address (if different from above)
City
State
Zip Code
Previous address (if at current address less than 2 years)
City
State
Zip Code
Your cell phone number
Spouse’s cell phone number
E-mail address
Name and address of nearest relative not living with you
Relationship
Telephone number of relative
SECTION 2. EMPLOYMENT INFORMATION
Your employer or business name
Business telephone number
Address
City
State
Zip Code
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Wage earner
Sole proprietor
Partner
How long employed:
________Year(s) _________Month(s) Occupation:___________________________________________________________
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Paid:
Weekly
Every two weeks
Monthly
Semi-monthly
Number of allowances claimed on Form W-4:_____________________
Spouse’s employer or business name
Business telephone number
Address
City
State
Zip Code
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Wage earner
Sole proprietor
Partner
How long employed:
________Year(s) _________Month(s) Occupation:___________________________________________________________
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Paid:
Weekly
Every two weeks
Monthly
Semi-monthly
Number of allowances claimed on Form W-4:_____________________
How will you get the funds for your offer? (Example: savings, loan, credit card, borrow from family, etc.)