Schedule 1 - Delinquent Tenant Report - Delaware Manufactured Home Relocation Trust Fund

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DELAWARE MANUFACTURED HOME RELOCATION TRUST FUND
*DF44113019999*
Schedule 1 - Delinquent Tenant Report
MANUFACTURED-HOME
ACCOUNT NUMBER
REPORT FOR QUARTER ENDING:
BUSINESS CODE GROUP DESCRIPTION
COMMUNITY OWNER
200 RELOCATFEE
0-000000000-000
NUMBER OF MONTHS
TOTAL AMOUNT
NAME OF DELINQUENT TENANT
STREET ADDRESS
CITY
STATE
ZIP CODE
DELINQUENT
OUTSTANDING
TOTAL
$
Mail This Form With Remittance Payable To:
Delaware Division of Revenue
P.O. Box 2340, Wilmington, DE 19899-2340
AUTHORIZED SIGNATURE
I declare under penalties of perjury, that this
DATE
TELEPHONE NUMBER
E-MAIL ADDRESS
is a true, correct and complete return.

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