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Formation below and then complete either Section 1 (pages 1 through 4) or Section 2 (pages 5 through 8). Do not complete both sections. All filers enter tax period: beginning ending File this claim with your Form IT-201, IT-203, IT-204, or IT-205. See Form IT-604-I, Instructions for Form IT-604, for assistance. Name(s) as shown on your return Taxpayer identification number Name of empire zone (EZ) Employer identification number (EIN) of QEZE Name of qualified empire zone enterprise (QEZE) b.
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