Get LA WT-02 2016-2021
HYSICAL ADDRESS: STATE: ZIPCODE: STATE: ZIPCODE: STREET: (if different than mailing) CITY: CONTACT NAME: PHONE NUMBER: EMAIL: Check this box if changes have been made to the information above. Check this box if you are no longer in business of selling tires. Indicate the date you no longer operate at this location here: / / File a separate report for each month Report is due no later than the 20th of month after the reporting month (Example: January report is due by February 2.
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