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Name of the Company: ................................................................................ 2. TIN/UTIN: - - 3. TCAN: - - 4. (a) Circle: .................................. (b) Taxes Zone: ............................................. 5. Deduction/Collection Period: (a) 1st quarter (July-September), (b) 2nd quarter (October-December), (c) 3rd quarter (January-March), (d) 4th quarter (April-June), 6. (a) Address: Year ........ ; Year ........ ; Year ........ ; Year .

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