Transcription of Missouri State Humane Association STATEMENT …
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Missouri State Humane Association STATEMENT …
CONTRIBUTION AMOUNT*: $PAYMENT DATE:AUTHORIZED SIGNATURE:*NOTE: The minimum contribution for a single year registration is $ The minimum contribution for a biennial registration is $ AUTHORIZATION STATEMENTDUPLICATE AUTHORIZATION STATEMENTM issouri State Humane AssociationEmbEmbEmbEmbEmblem Use Authorizalem Use Authorizalem Use Authorizalem Use Authorizalem Use Authorization Station Station Station Station StatementtementtementtementtementSTATEME NT NUMBER (OPTIONAL):ORGANIZATION CONTACT INFORMATIONAPPLICANT INFORMATIONNAME (LAST, FIRST, MIDDLE):MAILING ADDRESS:CITY: State :ZIP:TELEPHONE NUMBER (S)E-MAIL ADDRESS:CONTRIBUTION INFORMATIONDOR USE ONLY ANNUAL INITIAL REGISTRATION:INITIAL PLATE PICK-UP, BIENNIAL REGISTRATION:Q: What is an Emblem Use Authorization STATEMENT ?A: When a vehicle owner wants to obtain a specialty license plate from theMissouri Department of Revenue, the application must include an originalEmblem Use Authorization STATEMENT issued by the organization shownon the specialty license plate.
Title: MoSHA Application Author: Davi Subject: MoSHA Application Keywords: missouri,mo,humane,association,license,plate,humane,society,spay,neuter,adopt,cat,cats,dog ...
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