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Get (please Read Instructions Before Completing This Form) - Ttb Treas

D instructions before completing this form) 1. PRINCIPAL (Name of Partnership, Corporation, Association, Limited Liability Company, Estate, or Individual) 2. BUSINESS IN WHICH ENGAGED 3. ADDRESS (Number, Street, City, State, ZIP Code), TELEPHONE NUMBER, AND E-MAIL ADDRESS PERMIT NUMBER / REGISTRY NUMBER (If applicable) 4. PRINCIPAL'S EMPLOYER IDENTIFICATION NUMBER (Employer Identification Number or Social Security Number) 6. NAME, TELEPHONE NUMBER, AND E-MAIL ADDRESS OF APPOINTED ATTORN.

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