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DBPR Form AB T 4000A-004 Revised 06/09 61A-10. 008 FAC DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-1022 APPLICATION FOR REFUND OR CREDIT OF CIGARETTE STAMPS Permit Name Address Phone No. Permit No. State Zip City Email Address REQUEST FOR CREDIT REFUND PART I CERTIFICATE OF PACKAGE RETURNS TO MANUFACTURERS All returns to manufacturers must be accompa.

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