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| Name | Your Date of Birth | Address | Phone | Email | County (where you live) | Spouse's Name | Spouse's Date of Birth | Spouse's Address | Spouse's County (where they live) | Number of Children Shared with Current Spouse | Child 1 Name | Child 1 DOB | Child 2 Name | Child 2 DOB | Child 3 Name | Child 3 DOB | Additional Children with Current Spouse | Marriage Date | Separation Date | Occupation | Employer Name | Number of Exemptions Claimed on Taxes | Pay Period | Link to Edit Entry |
| Name | Your Date of Birth | Address | Phone | Email | County (where you live) | Spouse's Name | Spouse's Date of Birth | Spouse's Address | Spouse's County (where they live) | Number of Children Shared with Current Spouse | Child 1 Name | Child 1 DOB | Child 2 Name | Child 2 DOB | Child 3 Name | Child 3 DOB | Additional Children with Current Spouse | Marriage Date | Separation Date | Occupation | Employer Name | Number of Exemptions Claimed on Taxes | Pay Period | Link to Edit Entry |