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Speaker Request Form
Program Information
Program Date
(mm/dd/yyyy):
Start Time
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AM
PM
Name of Group or Organization Requesting Speaker:
Location
(city, state):
Presentation Topic:
Tax Implications for Starting A Business
Withholding 101
Sales and Use Tax 101
Common Interactions with DOR
Other
Desired Length of Presentation:
1 hour
2 hours
3 hours
4 hours
Number Expected to Attend:
Contact Information
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Address:
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Phone Number
((xxx) xxx-xxxx
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