Child Tax Dependent Claim Form

Child Tax Dependent Claim Form
Please complete this form to provide information required to claim a child as a dependent for tax purposes.
Claimant's Full Name*
First NameLast Name
Claimant's Email Address*
example@example.com
Claimant's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Claimant's Address*
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Child's Full Name*
First NameLast Name
Child's Date of Birth*
MonthDayYear
Date
Relationship to Child*
YesNo
YesNo
YesNoNot Sure
Additional Information or Comments (optional)
Should be Empty: