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Get NY DTF TP-592.2 2013

Name of representative or person to contact Address of claimant Address of person to contact City, village or post office City, village or post office State ZIP code Telephone number ( ) Firm name, if applicable State ZIP code Location of property conveyed (list each lot separately; attach additional sheets if necessary) Address County Address County Date of transfer (mm/dd/yyyy) 1 Amount of tax paid by claimant/assignor .

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