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EFTA00175998
cceptable. tinder penoltlon of perjury. I &Worn that I have ex5mIned eda return and accompanying docrumenta, and, to lino best of my knovrierice and bo!cf, they era too, correct, and CoriPlOtai Signature * instructio6s 1 , • FILE COPY Tide r- DORS Trtrium Date 2e4 ,2c When to file. File Form 10
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