Mississippi
Form 83-105-11-8-4-000 (Rev. 08/11)
Corporate Income and Franchise Tax Return
2011
831051184000
Page 4
FEIN
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SUPPLEMENTAL CORPORATE AFFILIATION SCHEDULE
List all entities owned by and affiliated with the corporation. Continued from page 2, part III.
Entity Name
FEIN
Address
Entity Type
Additional Page ____ of ____