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Must be submitted for each year an EITC/OSTC is awarded. SECTION I START Pass-Through Entity Name: Date Received: Department Use Only Address: Telephone Number: ➜ Fax Number: Email Address: 1. Total EITC/OSTC awarded Identification Number (FEIN, SSN): in tax year YYYY available for pass through 2. Forwarding pass-through entity FEIN: 3. Record of contributions: Contribution Date: Amount: $ $ $ $ $ TOTAL $ NOTE: Please answer “yes” to only one of the following questions, as an...
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