Form 13321 - Low Income Taxpayer Clinic (Litc) Conference Registration
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1Low Income Taxpayer Clinic (LITC)
Conference Registration
LITC name
Address
City
State
Zip Code
Attendee Name
Title
Phone number
Fax number
E-mail address
Emergency Contact Name & Telephone Number
Additional Attendee Information
Attendee name
Title
Phone number
Fax number
E-mail address
Emergency Contact Name & Telephone Number
Additional Attendee Information
Attendee name
Title
Phone number
Fax number
E-mail address
Emergency Contact Name & Telephone Number
Please note any accommodations you may need due to a disability:
Email completed form to Gerard.E.Pieger@irs.gov
13321
Catalog Number 34831J
publish.no.irs.gov
Department of the Treasury - Internal Revenue Service
Form
(Rev. 11-2006)
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Parent category: Financial