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Get CT DRS CT-941X 2012

Or document to DRS is a ne of not more than $5,000, imprisonment for not more than ve years, or both. Sign Here Signature of employer Keep a copy Paid preparer s signature of this return for your Firm name and address records. Date Date FEIN Telephone number ( Complete the explanation of changes section on reverse. ) Explanation of Changes to the Connecticut Reconciliation Enter the line number from Page 1 for each item you are changing and give the reason for each change.

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