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                                     DETACH HERE AND MAIL BOTTOM PORTION WITH YOUR PAYMENT

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DE 1100-V                                   Electronic 
DELAWARE DIVISION                           Filer  
OF REVENUE
                        2017                Payment 
                                            Voucher
1.Enter your Employer Identification Number                    2.Enter the amount of payment you are making.

                                                               $
3.Business entity is a:                     4.Corporation name:

                                            Address
        Corporation     S Corporation 
                                            City                                     State           Zip Code

(Revised 10/201 )7                                                         *DF68116019999*
                                                                                             DF68116019999






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