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Get AK Form 877 2012-2021

Tion of prize. Receipt Number Permittee Name Alaska An attached invoice can be substituted for description of prize. Receipt Number Permittee Name Operator Name Alaska Permittee Name Operator Name 0405-877 Rev 10/12 Bingo Game Number Operator Name Date Won Gaming Location - Street Address, City Bingo Game Number Gaming Location - Street Address, City Date Won Gaming Location - Street Address, City Bingo Game Number Amount Won or Description of Prize Date Won Amount Won or Descrip.

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