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UNITED STATES DEPARTMENT OF THE INTERIORForm 36041a (August 2013)FORM APPROVED OMB NO. 10040001 Expires August 31, 2016FREE USE PERMIT APPLICATION MINERAL MATERIALBUREAU OF LAND MANAGEMENT FIELD OFFICE
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Form 3604-1a is a tax form used for reporting certain financial information to the IRS.
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The purpose of form 3604-1a is to report specific financial information to the IRS for tax purposes.
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