form 10492

By Name Title ID number Telephone number Catalog No. 65710D Signature Form 10492 Rev. 1-2005. Department of the Treasury Internal Revenue Service 10492 Form Rev. January 2005 Escrow or Docket number Notice of Federal Taxes Due To Name of Escrow Holder Agent of Taxpayer or Fiduciary Amount due Address Number Street P.
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form 10492
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