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Officer. TAXPAYER'S SIGNATURE 45841012 OWNER, PARTNER OR TITLE DATE Instructions Failure to file all appropriate returns through the closing date may result in the issuance of notices/assessments by the Department of Revenue. Make sure that all applicable sections of this form are accurately completed. Incomplete information will not be accepted. You MUST return your ABL or Tobacco license(s) to close your account. Refund of unused ABL license fees: If the business is closed, moved, or sold.

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