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Type of Vehicle for Which Refund is Requested - Fill in applicable circle Concrete mixing Mulch blowing Bulk lime delivery to farms Solid waste compacting Bulk feed delivery to poultry or livestock Septage Removal Tank wagon motor fuel delivery Bulk fertilizer delivery to farms Sweeper Part 1. Income Tax Return Filed 2014 Gas-1200C refund claim Mailing Address FEIN or SSN No dashes City State Name of Contact Person Phone Number Zip Code First 5 digits Fax Number OFFICE USE ONLY Refund for...
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