vs19.pdf

File name: 

vs19.pdf
application/pdf Download vs19.pdf (45.32 KB)

Form ID: 

VS-19

Purpose: 

To be completed in addition to the Request for Business Amendment / Duplicate Certificate (MV-253G) when a facility reports a change in location.

Form title: 

Statement of Ownership and/or Permission to Use Place of Business

Document type: 

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