Sales And Use Tax Registration Application Form Page 4

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Louisiana Association of Tax Administrators
Page 4 of 4
Applicant Signature:
Title:
Preparer Signature:
Date:
(01/01/2010)
By checking this box, I affirm that the information given on this application is true and correct. I understand that if I
submit my application by email, my typed name is equivalent to an electronic signature. I understand that if I submit my
application by mail with a typed name, my typed name is equivalent to a handwritten signature.
4/27/2012

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