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Get W 9 Form Kansas Rev January 2005

Ive form to the requester. Do not send to the IRS. Name (as shown on your income tax return) Business name, if different from above Check appropriate box: Individual/ Sole proprietor Corporation Partnership Address (number, street, and apt. or suite no.) Other Exempt from backup withholding Requester s name and address (optional) City, state, and ZIP code List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box.

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