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Get New York St 129 1000 Fillable Form

K State, or political subdivisions of New York State. Name of hotel, motel, lodging house, etc. Dates of occupancy From: Number and street / City, village, or post office / State / To: ZIP code / Country US This is to certify that I, the undersigned, am a representative of the department, agency, or instrumentality of New York State, the United States government, or the political subdivision of New York State indicated below; that the charges for the occupancy at the above establishmen.

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