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Get LA LDR R-5679 2006-2024

R-5679 3/06 International Fuel Tax Agreement IFTA Decal Request Form Please print or type. Year New Request Renewal Additional Account Number Legal Name Trade Name Current Mailing Address City State Contact Person Telephone ZIP List additional states for which you anticipate travel if not previously reported List states where bulk fuel is stored if any Request for Decals Two IFTA decals are required for each Qualified Motor Vehicle operated. One decal must be placed on the passenger s side and o.

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