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Get OR DoR 150-800-743 2004

ART 1 TO BE COMPLETED BY APPLICANT Applicant Name (Last, First, Middle Initial) Check one Street Address Owner Social Security Number (SSN)* Employee City State ZIP Code Business Name Employer Identification Number (EIN) DBA (doing business as), If applicable Oregon Business Identification Number (BIN) Business Street Address City Business Daytime Telephone Number Type of Business (check one) State Fax Number Sole Proprietor ZIP Code Other Telephone Number Partnership.

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