FYI Income 20 United States Government Interest

Claim for Lost, Stolen, or Destroyed United States Savings Bonds. IMPORTANT: Follow instructions in filling out this form. Making any false, fictitious, or fraudulent claim or statement to the United States is a crimeand may be prosecuted. Print in ink or type all information. 1. DESCRIPTION OF BONDS. Describe the missing bonds in the spaces below. ................
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