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R appropriate dates MM D D Y Y Y Y MM D D Y Y Y Y NAME OF PARTNER ADDRESS TAXPAYER IDENTIFICATION NUMBER CITY/TOWN/POST OFFICE STATE NAME OF PARTNERSHIP ADDRESS Tax year ending ZIP + 4 FEDERAL IDENTIFICATION NUMBER CITY/TOWN/POST OFFICE STATE ZIP + 4 A. Type of partner (fill in one only): Individual resident Individual nonresident Resident trust or estate Nonresident trust or estate S corporation Partnership or other PTE IRA Corporation Ch 62 exempt organization Ch 63 exempt.

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