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Get Nh Road Toll Refund Farm Form

GOV/DIVISIONS/ADMINISTRATION/ ROADTOLL/ Period FOR OFFICIAL USE ONLY By APPROVED Class Claim Numbers Date Gals DISALLOWED Reason s ROAD TOLL REFUND APPLICATION FARM USE ONLY Farm Location NAME OF APPLICANT STREET CITY/TOWN NH STATE ZIP CODE TELEPHONE NUMBER This is to certify that the above has purchased motor fuel upon which the road toll has been paid and subsequently used in motor vehicles owned by the applicant for Farming purposes in accorda.

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