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2. AMENDMENTIMODIFICATION NO. MI21 1 I 3. EFFECTIVE DATE See Block 16c I 6. ISSUED BY I1 DEAC07051D14517 4. REQUlSlTlONlPURCHASE REQ. NO. NOR I CODE U.S. Department of Energy Idaho Operations Office
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mi21 1 i 3 is a specific tax form used to report certain income.
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