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OFFICE USE ONLY VCR# 2017 Form 21165ACCT# APPLICATION FOR REFUND FOR PERSONS 65 YEARS OR OVER INITIALS Date your refund claim is for wages earned outside Fayette County or reimbursed expenses, you
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This is a form or document specifically for individuals who are 65 years old.
Any individual who is 65 years old is required to file this form.
To fill out this form, individuals who are 65 years old must provide all required personal and financial information.
The purpose of this form is to collect necessary information from individuals who are 65 years old for tax or other administrative purposes.
Information such as income, assets, deductions, and other relevant financial details must be reported on this form for individuals who are 65 years old.
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