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State of Connecticut Department of Revenue Services 25 Sigourney Street Hartford CT 06106-5032 FORM APL-004 Deposit in the Nature of a Cash Bond Rev. 09/00 Conn. Gen. Stat. Attach a check or money order made payable to Commissioner of Revenue Services to this form. Does Filing Form APL-004 Constitute a Protest of the Assessment Filing Form APL-004 does not in and of itself constitute filing a protest of an assessment. Form APL-004 should be used .

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