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DD STAPLES, COMMISSIONER SECTION A 1 VERIFICATION INFORMATION Full Legal Business Name TDA Client No. TDA License No. (TPCL) Please provide only the information below that has changed. SECTION B 1 APPLICANT INFORMATION Full Legal Business Name (owner s name if sole proprietor no aliases) DBA (if applicable) 1 CHANGE OF OWNERSHIP CANNOT BE REGISTERED WITH THIS FORM If the tax identification number of your business has changed, a new application and fee is required. A new tax iden.

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