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Insurance Code) Attach a copy of State Page and Schedule T or Page 3 Income Statement and Page 5 Premium Schedule to this tax report. COMPANY INFORMATION AND MAILING ADDRESS Complete all Company Information. List the address and contact person to whom annual tax and/or fees information or questions should be directed. IMPORTANT: The Sponsored Captive Company Name, EIN and NAIC # must be entered at the top of Page 2. PART 1 WFC-1 COMBINED PREMIUM TAX SUMMARY FOR CALENDAR YEAR 2008 INSTRUCTI.

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