Form 578 - Seafood Marketing Assessment Annual Return - 2015 Page 2

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2015 Seafood Marketing Assessment
578
Annual Return
Form
Taxpayer Name
EIN or SSN
C. Value of Seafood Products
A. Fish. Bus. Lic. #
B. Facility Location or Vessel Name
(Line 6, parts I & II, page 2 from
each fisheries tax return)
0405-578 Rev 01/01/16

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