Form St 26 - Application For Cumulative Return Authority Page 2
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2ST 26
Rev. 12/04
Page 2
The license numbers and addresses of each business location to be reported under the Cumulative Return Authority must
be listed in numerical sequence. Those business locations not yet licensed should also be listed indicating “applied for” in
the license number column and the address in the address column.
License Number
Street Address
City and ZIP Code
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Parent category: Financial