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CP 91 Sample Contents Page 2

Contents of This Notice - Page 2 of 2

[The second page of CP 91 has a list of outstanding accounts in the following format:]

Form Number Tax Period Assessed Balance Statutory Additions Amount You Owe
Paying Late Penalty Interest
{form #} {date} $.00 $.00 $.00 $.00
Page Last Reviewed or Updated: 2012-08-12