Exhibit 4.2.1-3
(10-01-2003) Pattern Letter P-429
Dear [insert taxpayer's name]
We have received your
check dated [insert date], for $[amount], which will be applied as payment
against the deficiency disclosed by our examination of your [state year] Federal
income tax return.
Thank you for your cooperation.
Sincerely yours, [Signature] [Title]
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