Provider Application and Notice for new firms


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Title Provider Application and Notice for new firms
Description

Complete this application and the StateWide Payee W-9 if you are applying for a firm Provider Number with L&I.

Document number F252-088-000
How to get this document
Keywords vocational, vocational application, vocational provider
Alt Language(s)
Valid dates 05/2014
Contact information Vocational Resources
Websites

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