Rts-9, 2013, Application For Agent Registration Page 2

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RTS-9
R. 01/13
Page 2
Client Name and Mailing Address
RT
FEIN
*Effective
Account No.
Begin Date
*Effective Begin Date is the date you begin representing your client. This date must be the beginning of a reporting period
(i.e., 1/1/07, 4/1/07, 7/1/07, 10/1/07).
(Attach additional sheets, if necessary.)

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