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Get AL SR2 2003

APPLICATION TO DETERMINE LIABILITY IMPORTANT NOTICE Under Alabama law you are required to furnish the information requested on this application. Each false statement or refusal to furnish information on this report, or willful refusal to make contributions or other payments is punishable by fine or imprisonment, or both, and each day of such refusal shall constitute a separate offense. EMPLOYER NAME AND MAILING ADDRESS j k FEDERAL EMPLOYER I.D. NUMBER (FEIN) This number is assigned by the .

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