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Standard Form 1199A (EG)OMB No. 15100007(Rev. June 1987)
Prescribed by Treasury
Department
Treasury Dept. Cir. 1076DIRECT DEPOSIT SIGN UP REDIRECTIONS
The claim number and type of payment are printed
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What is as representative of form?
As representative of form is a document used to designate an individual or entity to act on behalf of another party in a legal or administrative matter.
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As representative of form typically requires information about the representative's identity and contact information, as well as details about the party they are representing.
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