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6. Area Code/Phone Number 3. Mailing address 7. Address of Records/Payroll 4. City, State, Zip 8. City, State, Zip 9. Owners or Officers Name Soc. Sec. No. 10. Business location(s) in Texas Trade Name Title Residence Address, City, State Street Address, City Kind of Business No. Employees Acquisition Section 11. If you acquired the business in Texas from a previous owner, you must complete Items 11-14. Mo. Day Yr. Acquisition Date : Previous Owner s TWC Account Number (.

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