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Get 1092 Form

Beginning , 19 , and ending Name of corporation Class of stock OMB No. 1545-0044 Number of shares outstanding on first day of tax year Number of shares outstanding on last day of tax year Expires 8-31-95 , 19 Employer identification number Description of dividend rights Actual distributions per share made in tax year * * If a distribution was not made on all shares of any class, describe any unequal treatment: Describe any other changes in outstanding stock during the tax year: (U.

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