If Form 1040, ‘PrimaryClaimAsDependentInd’ is not checked, then the Primary SSN must not be the same as a Dependent SSN on another return filed for the same tax year.

The Dependent's was claimed by someone else on another tax return or the dependent filed his/her own tax return.

Dependent's Name:
Dependent's Social Security Number

Federal Refund with Dependent: 
Federal Refund without Dependent: 

State Refund with Dependent:
State Refund without Dependent:

An additional $39.00 retransmit fee has been added to this tax return.

Please add $39.00 retransmit fee to this tax return.