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ENERAL INFORMATION 1. Name of Business 3. Return Period Year Month Day to 4. Address of Business (Apt. No., Street No. & Name, Postal Zone, Parish) Month Year Day 5. Tick appropriate box New Address Revised Return Section B: SUPPLIES (Goods & Services) Total Supplies made during Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . + 8 7 Taxable Supplies Zero-Rated Supplies Export Supplies Exempt Supplies + 9 10 (Subtract Line 10 from Line.

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