Get IN 53788 2008
by Auditor of State, 2008 Approved by State Board of Accounts, 2008 Daytime Telephone Number: Send completed form to Auditor of State, 240 Statehouse, 200 W. Washington St., Indianapolis, IN 46204 or fax to (317) 234-1916 Print or Type Legal Name (OWNER OF THE EIN OR SSN AS NAME APPEARS ON YOUR TAX RETURN. DO NOT ENTER THE BUSINESS NAME OF A SOLE PROPRIETORSHIP ON THIS LINE.) Trade Name (Doing Business as Name D/B/A) (Complete only if payment is to be made payable to the DBA name) Remit Addr.
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