Print this form and follow the steps. After your done fax to 713-228-4129

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Step 1 - Place Social Security Card and I.D. Card here.

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Child 1

Name________________________________________

 

Date of Birth ________________

 

 

Child 2

Name _______________________________________

 

Date of Birth ________________

 

Child 3

Name _______________________________________

 

Date of Birth ________________

 

Child 4

Name _______________________________________

 

Date of Birth ________________

 

Step 3- Only! if your claming depends

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Step 2- Fax in you last paycheck stub or your W2 form.