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Check if self-employed OMB No. 1545-0047 Department of the Treasury Internal Revenue Service Check if applicable: Address change Name change Initial return Termin- ated Amended return Gross receipts $ Applica- tion pending 132001 01-23-12 Beginning of Current Year Paid Preparer Use Only Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or priva…
