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Get Az Dor Form 830 2020-2024

T will be returned to you. All information is subject to verification. Disclosure of your Social Security Number (SSN) is voluntary. This information may be used to establish positive identification for purposes of criminal background checks pursuant to A.R.S. 5-404. Licensee s Name License Number Position (check the appropriate boxes): Manager Supervisor Proceed Coordinator Assistant REVENUE USE ONLY. DO NOT MARK IN THIS AREA. 88 Affiant s Name Social Security Numb.

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