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Get Lic 9163

Set Contributing Agency: CA Dept of Social Services 03502 Mail Code (five-digit code assigned by DOJ) Agency authorized to receive criminal history information PO BOX 944243 Street No. Mail Station 9-15-62 N/A Contact Name (Mandatory for all school submissions) Street or PO Box Sacramento, City CA 94244-2430 State ( Zip Code ) N/A Contact Telephone No. 5. Applicant Information: Name of Applicant: (Please print).

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