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Forms & Publications Texas Vaccines for Children DSHS

Forms & Publications Texas Vaccines for Children DSHS

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President Registered Agent CEO COO CFO Partner and Owner I certify that the information on this form is true and correct. If using an assumed dba name also submit your certificate of filing. Government Entity Hospital Authority/District/Foundation Sole Proprietorship or General Partnership Internal Revenue Service IRS or other documentation confirming your EIN. Non-Profit submit your certificate of filing. See http //www. dshs. state. tx. us for more information on Privacy Notification....
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