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Get Co Dor Dr 0145 2013

N Office Use Only Date Received: Taxpayer Last Name or Business Name First Name Middle Initial SSN, CAN or FEIN Spouse s Last Name, if returns are filed jointly First Name Middle Initial SSN or CAN Address City State Zip Mark only one (the department will accept the federal form 2848, Power of Attorney and Declaration of Representative, in lieu of this document): Tax Information Authorization: Marking this box allows the department to disclose your confidential tax inform.

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