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Fr 500 2015-2023
Registration (Part VI)
• Tobacco Products Excise Tax Registration (Part VII)
• Department of Health Care Finance (DHCF) (Part VIII)
• Miscellaneous Tax (Part IX)
• Form D-2848 OTR Power of Attorney
• Registration To Determine Unemployement Insurance Liability*
NOTES: Demographic information (Part 1, Line 13) is MANDATORY.
Failure to complete this form in full may result in your denial for an application for a license or
permit with other DC Government agencies.
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