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EFTA00175998
mplete. FILE COPY / 'Signature ra • TItle paani DENT Date a- 4 • -,70 / ( Instructions Purpose of form. Use this form to transmit paper Farms 1099, 1098 5498, and W-2G to the internal Revenue Service, Do not Use Fenn 1096 to transmit eleotronically or magnetically, For magnetic media, see For
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