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Get and Sign Type 2 Gaming Financial Report Indiana Atc Form
Business Address number and street city state ZIP code Business Telephone Area / Number A/B Permit Number Type II expiration date - Home Telephone Area / Number Mailing address number and street city state ZIP code Status Active Non-operational / Escrow Attach escrow letter County Enter financial accounting period for this license From To. m/d/y 1 Gross income Pull Tabs 3 Gross income Tip Boards 4 Total Gross Income add lines 1 - 3 5 Expenses Pull Tabs Payouts 6 Expenses Punchboards Payouts 7...
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