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Signature of Taxpayer Date Signature of Spouse If prepared by someone other than the taxpayer - Under penalties of perjury I declare to the best of my knowledge and belief the statements made herein are true and correct and that I am authorized by the taxpayer s to prepare this application. Signature of Preparer Preparer s Name FIN / PTIN File ORIGINAL and one copy with The Rhode Island Division of Taxation One Capitol Hill Providence RI 02908-58...
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