04-19 (FI) PA Department of Revenue P.O. Box 280503 ...
Property Tax or Rent Rebate Claim 04-19 (FI) PA Department of Revenue P.O. Box 280503 Harrisburg PA 17128-0503 OFFICIAL USE ONLY Your Social Security Number Spouse’s Social Security Number Check your label for accuracy. If incorrect, do not use the label. Complete Section I. Fill in only one oval in each section. I III If Spouse is II ... ................
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