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Get Midland National 6773Y 2005

JOINT TAXPAYER IDENTIFICATION NUMBER (TIN): Social Security Number - Employer Identification Number - - Certification - Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and; 2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service that I am subject to backup withholding .

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