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AMENDED RETURN LIST NUMBER OF NON-RESIDENT PARTNERS/SHAREHOLDERS: NAME OF BUSINESS EMPLOYER IDENTIFICATION OR SOCIAL SECURITY NUMBER ADDRESS CITY STATE ZIP CODE STATE ZIP CODE DELAWARE ADDRESS (IF DIFFERENT) CITY DATE OF INCORPORATION STATE OF INCORPORATION NATURE OF BUSINESS 1. DELAWARE SOURCED INCOME (NON-RESIDENTS ONLY)........................................................................................ 1. 2. TAX LIABILITY (MULTIPLY LINE 1 BY .0660 ).

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