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Get NY FSI 302 2011

Y) County Code - Est. No: Entity No. ___________________________ Receipt No. _________________________ ARTICLE 28 RETAIL FOOD STORE – LICENSE FEE: $250.00 License Period: 1/1/12-12/31/13 Certificate No. ______________________ INSTRUCTIONS Read and complete both sides of this application. Prepare a separate application for each location. Include license fee by check or money order payable to “Department of Agriculture and Markets”. Section (1) enter and explain any changes in names or .

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