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LLOCATION BY SUBOUTLET OF COMBINED STATE AND UNIFORM LOCAL SALES AND USE TAX Please round cents to the nearest whole dollar. The original copy of this schedule must be attached to your return. Read instructions before preparing. TAXING JURISDICTION IN WHICH PLACES OF BUSINESS ARE LOCATED SUB OUTLET NO. COLUMN 1 AMOUNT OF 1% COMBINED STATE AND LOCAL TAX COLUMN 3 TAX AREA CODE COLUMN 2 CO. JUR. ADD ON IN LIEU TOTAL: This Schedule C total must agree with line 17 of your return.

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