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Get AR DFA AR-1R 2012

State, Zip Code Contact Information a) Name b) Title d) E-Mail Address e) Fax Number c) Contact Phone Number: (including area code) 12. SECTION D - SIGNATURE Important - Read Before Signing. This registration form must be signed by a responsible party who is authorized to sign on behalf of the organization. The Proprietor must sign for sole proprietorship. I declare under the penalties of perjury that the information provided (including any accompanying statements) has been examined by me.

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