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55A004[removed]Page 1 COAL SEVERANCE TAX SELLER/PURCHASER CERTIFICATE
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Document Date: 2015-02-07 06:04:59


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File Size: 68,40 KB

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Holiday

Commonwealth Day / /

Organization

Kentucky DEPARTMENT OF REVENUE INSTRUCTIONS TO COMPLETE PAGE / Kentucky Department of Revenue Frankfort / Kentucky Department of Revenue / /

Person

Brokered Tons / /

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Position

producer / above Broker / Broker / SELLER/BROKER INFORMATION Certificate ID No. / Coal Broker / /

ProvinceOrState

Kentucky / /

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