Get OK Form 13-9 2012
Red vendor) or Account Number Street Address Telephone Number Period Covered by Claim: City State ZIP Name of Representative (provide Power of Attorney) Street Address City Refunds Claimed: Credit Claimed: Telephone Number Bank Routing Number: State ZIP Bank Account Number: Checking Savings No Checking or Savings Account (See certification below) By checking the box I certify that, as an individual, I DO NOT have a checking or savings account at a bank or financial institution.
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