med Boxes checked en Ca and (1b No. of children on 6c who: * Ned with you • did nettle., with you OA to &KW9 Cr separation lane rtstructmal Oroenclanteon fit. not inched elxnu Add nuntsece on lines ► above 2 1 3 Income 7 Wages, salaries, tips, etc. Attach Form(s) W-2 7 8a 91,404. 8a Tax