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Ouse s SSN (if applicable) City, Village, town, or post office State of incorporation (if applicable) State ZIP code 2. Appointee information Appointee s name Mailing address (include firm name, if applicable) Telephone number ( ) ( ) ( ) 3. Tax matter(s) The appointee is authorized to receive your confidential information (not including copies of tax returns) from the Tax Department for the tax matter(s) listed below. Type(s) of tax (income, sales, cor.

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