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Wi Dor A212 on Line 2016
Must also complete and
submit Form A‑213 Corporation Schedule A with this petition. NOTE: If your offer is accepted, you must pay that amount within
ten (10) days from the date the offer is accepted or pay in accordance with an approved payment schedule.
Social Security Number
1. Name of Petitioner
9-digit number; no hyphens
Business Address
Seller's Permit Number
15-digit number; no hyphens
Withholding Number
15-digit number; no hyphens
Business Telephone
(
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