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Mark all appropriate boxes with an X. 1 For the month of 2 Amended Return MM / YYYY Yes No Part I Background Information 5 TIN RDO Code August 2001 ENCS No. of Sheets Attached 4 Any Taxes Withheld 7 Line of Business Withholding Agent s Name 9 Telephone No. 10 Registered Address 11 Zip Code 12 Category of Withholding Agent Private Government 13 Are there payees availing of tax relief under Special Law or International Tax Treaty No If yes specify .

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