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MY INFORMATION×Please print and sign firmly in blue or black ink. Mr. Ms.
FIRST NAME Mrs. M.I.LAST NAMESAKE ADDRESSWORK PHONECITYPERSONAL MAILLOL RECOGNITION DOB (MM/DD/YYY):
/
/I have given to United
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My information my gift is a form that must be filed with the IRS to report gifts you have given that exceed the annual exclusion amount.
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Any individual who has given gifts that exceed the annual exclusion amount is required to file the my information my gift form.
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