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-3676) or Order Information Returns and Employer Returns Online, and we ll mail you the scannable forms and other products. See IRS Publications 1141, 1167, 1179 and other IRS resources for information about printing these tax forms. 9191 VOID CORRECTED 1a Total ordinary dividends PAYER S name, street address, city, state, ZIP code, and telephone no. OMB No. 1545-0110 2010 $ 1b Qualified dividends $ PAYER S federal identification number RECIPIENT S identification number RECIP.
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