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Get Ri Dot Ri-1041 2012

Ciary Yes Preparer s name (please print): SSN, PTIN or EIN Sign Here Telephone number ( Mail returns to: RI Division of Taxation, One Capitol Hill, Providence, RI 02908-5806 ) SCHEDULE I BENEFICIARY INFORMATION (All estates and trusts must complete this schedule) Name Address State of Residence Social Security Number 20. Beneficiary .......................... 21. Beneficiary .......................... 22. Beneficiary .......................... If more space is needed, please att.

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