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Form 4564 Information Document Request Dates of …

Dates of Previous Requests (mmddyyyy) Description of documents requested From: Information Due By At Next Appointment Mail in Name and Title of Requester Office Location Employee ID number Date (mmddyyyy) Telephone Number Part 1 - Taxpayer's File Copy ( ) Department of the Treasury — Internal Revenue Service

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  Information, Date, Document, Request, Locations, Information document request dates

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