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Annual Registration Invoice Request Form

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First Name (requestor)
Last Name
Email Address
Phone Number
Registration Number (if known)
Facility Name
Facility Location Address
Required if registration number is unknown
City
State
Zip Code
Disclaimer
Please note that this form is considered a public record subject to the terms of the Washington Public Records Act (PRA). For that reason, any information you provide on this form may be subject to public inspection and copying in the future.

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