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Bution Report FOR THE FISCAL YEAR JULY 1, 2010 - JUNE 30, 2011 TAXPAYER'S IDENTIFICATION NO. AMOUNT OF PAYMENT $ DESIRED RATE: % THIS FORM IS TO BE USED ONLY FOR THE PURPOSE OF SUBMITTING A VOLUNTARY PAYMENT OF ADDITIONAL CONTRIBUTIONS, IF ELIGIBLE AND IF YOU WISH TO MAKE SUCH A PAYMENT, IN ORDER TO ACQUIRE A MORE FAVORABLE RATE FOR THE CURRENT FISCAL YEAR. CONDITIONS GOVERNING VOLUNTARY CONTRIBUTIONS R.S. 43:.
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