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Get WASHINGTON STATE PATROL

H 43.43.845 RESET (Clears all Fields in the Form) (Instructions on Reverse Side) A B REQUESTING AGENCY/ADDRESS PURPOSE Check appropriate box Agency Attn Educational School District (ESD)/School District Volunteer no fee Address Non-Profit Business/Organization no fee (Excluding Schools & EDS s) Profit Business/Organization - $10 City/State/Zip Adoptive Parent - $10 I certify this request is made pursuant to and for the purpose indicated. Fees: Make payable to Washington.

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