Michael D. (age 49, DOB: 1/7/1970, SSN: 497-00-2146) and Susan L. (age 42, DOB: 4/1/1977, SSN: 421-00-1019) Smith live in a townhouse located at 3842 Timber Creek Drive, Your City, Your State - Your Zip. They both want to designate $3 of their taxes for the Presidential Election Campaign. The whole family was covered by health insurance all year.