Form 3833 - Application For Transfer Of S Corporation - Overpayments To Shareholders - 2002 Page 3

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Part II Distribution To Shareholders (continued)
Shareholder name
Social Security No.
Percentage
Amount of Overpayment to be Transferred
and address
or FEIN
of Ownership
(a)
(b)
(c)
(d)
383302304
FTB 3833
Side 3
(NEW 2002)
C1

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