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'I 'For “51: REVISED 5180 STATE OF OHIO DEPARTMENT OF NATURAL RESOURCES DIVISION OF OIL AND GAS PERMIT API WELL NUMBER 3 4083 28iiO EMT r 1 4 Date Issued 81/02/26 Permit Expires 81L/08LI2dS moon
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i forl ampquot is a specific form used for tax reporting purposes.
Individuals or businesses earning income that falls under the reporting requirements.
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