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OR LICENSE TO USE CERTIFIED LOGOS Firm Name *3316* I Contact Mailing Address City State Telephone Fax Zip E-Mail Type of Business Homepage Commodity or Products Sold Brand Name or Trademark Primary Source of Supply / Parish % Usage Out of State Source of Supply % Usage Symbol(s) to be used: Certified Product of Louisiana Certified Cajun Product of Louisiana Certified Creole Product of Louisiana Describe briefly how symbol(s) will be used: Whereas the Certified symbol(s) repr.

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