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Laura M. Economic Commissioner of the Revenue PO Box 99 New Kent, VA 23124 PH 804.966.9610 FAX 804.966.5562 businessadmin@newkentva.usOWNER TRADE NAME ADDRESS 1 ADDRESS 2 CITY, STATE ZIP2021 FORM

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Due May 3 form is a financial reporting form that must be submitted by certain individuals or organizations.

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