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523 GALL A. 'Application No, tjtij3 ...., ..... 1 'l, ;&::::l:. PERMIT ft ', ;t..., ...;. “ ':. ' Coal mailing instructions: YES NO (Instructions on reverse side, if yes).;f::: 1. Date time stamp
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It is a specific form for tax reporting purposes.
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The purpose is to report income and calculate taxes owed.
Income sources, deductions, and tax credits must be reported on the form.
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