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Enter the taxpayer s name, the last four digits of the taxpayer s federal identification number (FEIN) or social security number (SSN), whichever is applicable, and mailing address in the designated spaces of the form. (1) Obtain certification from the Department of Taxation (Department) by submitting a properly completed application on Form G-79 to the Department on or before March 15, 2013 (Note: Failure to file Form G-79 on or before March 15, 2013 will result in the disallowance of the.

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