|
olp 7,
<br />INSFIO K-11 .SNS 11)k CSS RLI,,, lNG $"ORM ''Al'
<br />s ton 1 3 '333. _3,` sfl'al. r,r corn. r °. il # Nrrm' (WISIGITS (a t sr`1t,r ,; st t"f'.
<br />a, d ii IA NMIL:r`.
<br />.,. S2tBWl' :SLY ONE (Q IDSM IDSWV 100VIM,o of We s'tet's,, of rmh ., r . ,z",
<br />1"?s_a fcnn should be 6.rmq:r,a,.d by cit, € W`va?"t ANT! JCAI7"° or rise LOCAL AlN(.°Y
<br />� f<, R-nSr a. 0R—
<br />Plane c "li ctady w,s ,r,}la; N, i .,,,.,..t, a.
<br />T"01 O),.
<br />�t �r.< Wd3.3.�, ONLY O. «< e as e ...
<br />Mad an Q) in be bon new 0) Me Am U n �vu descritt-0-i tile, the form is being corr"Pom"L
<br />I. 2.50.o,1 y< ru',i naa'.luk'.'+.. `R: rivOy .z. �"vr III.' c-Om Id,
<br />?.?.,$:' e am! addrson r`1t,aim ;:5:'. o dw u7xt8'w a"iiiiys S..
<br />c
<br />t
<br />Add3". s. °t'. ._. t3, have r.i "hid $,., 'til imallon i.r.a;?.i. `j, Swvaicr Li'i{S Ire) €:".i&.
<br />Sf
<br />...
<br />include ,rM.am;96 ones s€ia.r,t a; - of ?;is>'"'. n>Ls,.Ye3..
<br />°=we r79�e7be u..t ini3v�e azi arida pcod— �� um ..;t� H _ugz;tbe.,gr i ,xr;gc sa��s_,<�,g�y¢�c<'"a%F3R��EY in tpriTc WWW
<br />flh rk, .:d=e ppro> ri,,aft. lv�oi for & ArPE OF J,-fU..4a_Nf`.,,:kS ��'/Sr Nk'.RSHIP i(°,..c« x �.Q,ISiASF3��°�.�"'cTt�. N5 iN. )? IDt,AL,
<br />1, Check Itle appropriate bos lot (,)F BUSINIFNS,
<br />�m
<br />�_ >' 1,ws,hty/S.{". is amwraa, wink an 2ra.u3,eid reservation or e,o:7er" fnTarx ssrv:r ray<Js. Ilia WWe ? ., zaett "Wh"
<br />,
<br />6. ON= r"r;^ kttz b.t. ,'34:§;Y .. TANKS ,.+<ro,.S aAs 1911', ..
<br />R=NA i t:"le IRA. 3 n J or sube ?,,r, E in the space p>:radeted.
<br />H, PR(THRIT t.S ,rNE " 411-1;51MI <"153" ADI) SS (IsfLJSF BE (-OMP a a; 11))
<br />C, ail 7.2;5:`..S.i." 38'ithis saum,. €...i.ss.a he,S; :trtt. As <r::,it ttS,C1`C:):ti i, if tire same. We"SAW AS ;W," ;wam
<br />nis maim Ik sum to dhw(,!� 111'�(,1pElN1`il7 OWNFIVS 111, TYPE box,
<br />c_m.;re_", a1fi stedrn it rirr., ,e_r.En unto. ar,,,. am Ehu s.--3r:se "€s SJ Ci'O, 1; If , AS, .,IN
<br />IF," across
<br />this 7.4:. g t. Be ; erre. to <.i.. ,, Te'3s Nfi;`T ` P , box,
<br />V. YICISJUD Oil 1IUkJA1JZAFf0N .`i° S"IOp SGS, r`aC';OUNfT NU t "1° BECOMPTli.IA:gip
<br />Enter your Bomf of I;r,W,, .v (DOE) u r st=r;r°zje we mac'3u.rr€ true PSer wed, s reiluireti trAw }>e„ p,,:r"r .r, .r,,O=.z<rt€r:rS
<br />n So prolcmmd, lWs,;rs <...., ; mh .ho ax A, .e7,3J ensure finat vtia¢ will receive a quarterly st ,rn� s.fee return in, r p ei,i.,t>, tfar.>
<br />� ,ji�t
<br />,� all'fey clue mt the number rpt l<rHore; plead in 3exur i `�s'IT 'tits BOE ;,t code perst , �. �3rm r =coal
<br />(,r mills) per gallon
<br />t t hg We, am pw teen so ,efrurm MH nch be sent. H you do ncrt hue an account nurnber with fhc BOE, or if you havc all,
<br />qi.it.snots, regarding t€s be or cremptims, Ideals: call the WE at 9161219555 or ixi' e to Me $30¢1 a, fba
<br />St'x',d of 1 trldtifion, i:wAso.E;t nhil lies Uniq PD, [lox 94287% Sacramento, CA AU7edANI,
<br />Sy, rpt,,'TR ;at,l'1;.1M U[Si''INlYti SIALU-NPON a°t'ILI (WISF BOMPT,I+,:t :t)
<br />es..Ct, e, y xe2f. i.,3.;35$ >C#,„7 uu r by A,< ;,r t`gtr ans,7-/fzr s. r, t'wor in ,.Yia.`c,zik5.�� the "i.d:fra.Y,i dtT(2< :'si£ite ” ,.ar�wa�s- .?,p.t@4sri "s€}t„r
<br />. .nL,.eb,...,. US” ox ed by my t edzi-al or State agency are eY,eo33p3t frorn this requir'u pent, -
<br />VL I,,,sr h~ NkvOTm tA. affs.SN AND Hd iLIN(, ar.Ed" 1'-1S1
<br />(1.tt, :BOX aNr the andress AM vol he raced f4aY.WHI 11-,GAL H'. mING N(Y11FICA11ONN,
<br />APPLICAIrly., ML111 t SIGN AND D f ', a'tuFIly,)Rylf AS IDI X111).
<br />,
<br />.. d can be 3s wired by a0irr the^. Sent.. pia d ,,ap{y;791 24.:.x. le
<br />r.�� U�e�t <.t�tt,3t.,r�a_,.,.�.. ,.._, sEr ��e � t��.F�.a�n�.rr:6 � ��
<br />W ."N ,nu r,bcr r. ,, b :a.r,_.< t t� , ge.7e.. ...� Esc, , rh.Ps ti<z<_St:er um be nurneriond a7" c3 r �ra,.7rd, ammin
<br />b 3.car. =1. agno Prefem Me psis;: s.«z,t t<.-, ao gn the facility amnbcr, pimuse 1> blank,
<br />3t is 1W, e < ttt 3f.., 1r (N7 17111 fi , . A1 sf".lI a;:"Y INSPECES 111E FACILWY T VERIFY 111P,
<br />A()'1tRAa" ` £r 'rRx; 'pr f , tN [ON, rpt 4 APesr,tfprS3'1.ON GO":t' BE, PROC `,SSED HP 111 t S J Af..SI'ARNI'
<br />s r„ Bs,K3 IS N z . z.,.'_II IN. 1W 2, t1. e1.< A(ITINCY 15a RESPONSIBLE FORTHE, COM LE-1 0 OF-111E
<br />A,(IT II ?< ITS,11 ONEW INIVORMATH114 WXAND FOR P13 t' int ONE, Fy)R&I WAND
<br />"a_ .. 'DC), cs3; 11,10,LLOWING .AEUMESSm
<br />SIAPT NVATITIR RHISRLJR(a.p2 (DWROL
<br />J :xf PU_0f,R, "ING CTA t
<br />P& BOX 27
<br />CA 90'23
<br />
|