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Get In Sf 47478 2010

E: (317)-234-3009 E-mail: pla9@pla.in.gov www.pla.in.gov State Form 47478 (R6 / 12-10) Approved by State Board of Accounts, 2011 * Your Social Security number is being requested by this state agency in accordance with Indiana Code. Social Security numbers are available to the Indiana Department of Revenue. INSTRUCTIONS: 1. 2. 3. 4. Disclosure is mandatory and this record cannot be processed without it. Please type or print legibly. Include a fee of $10.00 unless selecting Inactive or Unass.

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