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SAVE $25VIA PREPAID CARDMAILIN REBATE ONLINE PURCHASES ONLY, TWO SUBMISSIONS PER HOUSEHOLDS imply follow the instructions below to complete this form. Please print clearly. Complete the form and mail
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Form 1234
Individuals earning over $50,000 per year
Fill out all sections accurately and completely
To report income and expenses for tax purposes
Income, expenses, deductions, and credits
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