| http://www.w3.org/ns/prov#value | - ____________ Name (_____)_____ - ______________ Daytime telephone ____________________________________________________________ Address ___ ___ ___-___ ___-___ ___ ___ ___ Social Security number (SSN) Check all tax types for which you are responsible for filing returns and paying the tax or fee due. ___ Withholding Income Tax ___ Motor Vehicle Renting Tax ___ Motor Fuel Tax ___ Sales, Service & Use
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