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TEXAS DEPARTMENT OF STATE HEALTH SERVICES 1100 West 49th Street Austin, Texas 78756 P.O. Box 149347 Austin, Texas 787149347 18889637111 www.dshs.state.tx.us TTY: 18007352989 DAVID L. LAKE, M.D. COMMISSIONER
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Information concerning form self-certification is a document that certifies that the information provided is accurate and complete.
Individuals or entities who are required by law or regulation to provide accurate information about themselves or their activities.
The form usually requires personal or business information to be filled out, such as name, address, contact information, and the relevant details being certified.
The purpose of the form is to ensure that the information provided is accurate and complete, and to certify that the person or entity understands and complies with the relevant laws and regulations.
The specific information required on the form will vary depending on the purpose of the certification, but generally includes personal or business details, declarations, and signatures.
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