Form Rpd-41238 - Application For Rural Job Tax Credit
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1RPD - 41238
INT. 02/2001
APPLICATION FOR RURAL JOB TAX CREDIT
PLEASE PRINT OR TYPE
A certificate is required for each eligible job
Pursuant to Paragraphs (1), (2), and (3), 25 U.S.C. Section 51c.
Multiply line 2 by .0625
_________________________________________
___________________________________
Taxpayer Signature
Title
_________________________________________
___________________________________
Telephone Number
Date
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Parent category: Financial