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Case 1912122KGDoc 2886Filed 10/24/19Page 1 of 4Annex 1E
Declaration of Intent to Claim a Worthless Stock Deductions×DE:225927.1 28709/001Case 1912122KGDoc 2886Filed 10/24/19Page 2 of 4IN THE UNITED
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It is a declaration form used to report certain information to the relevant authority.
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