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Form 941c Supporting Statement To Correct Information OMB No. 15450256 Do Not File Separately (Rev. October 2006) Department of the Treasury Internal Revenue Service Page No. File with Forms 941,

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This form supports adjustments for financial transactions.

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Individuals or businesses involved in financial transactions are required to file this form.

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The purpose of this form is to report any changes or corrections needed to financial transactions.

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Information such as the original transaction details, adjustments needed, and reasons for the adjustments must be reported.

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