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Preparer Information: (Individual’s Name, Street Address, City, Zip, Phone)
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Taxpayer Information: (Individual/Company Name, Street Address, City, Zip, Phone)
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Return Document to: (Individual/Company Name, Street Address, City, Zip, Phone)
Type of Document: ________________________________
Grantors: Grantees:
See Page _____________ for Legal Description:
Book & Page Reference: