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State of California Health and Human Services Agency Department of Public Health SECTION 1424 NOTICE Page 1 of 4 CITATION NUMBER: 1512840009262S Date: YOU ARE HEREBY FOUND IN VIOLATION OF APPLICABLE
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Obtain the redacted-9262 form from the California Department.
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Carefully read the instructions provided with the form to ensure you understand the requirements and guidelines.
03
Fill in your personal information accurately, such as your full name, address, and contact information.
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Provide any additional required information, such as your social security number or taxpayer identification number.
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Clearly state the purpose for filling out the redacted-9262 form, whether it is for a license, permit, registration, or any other specific requirement.
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Follow any additional submission instructions provided by the California Department, such as mailing or delivering the form to the appropriate office.

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Individuals applying for a license or permit from the California Department may need to fill out the redacted-9262 form.
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Businesses or organizations that need to register for specific services or activities regulated by the California Department may also require this form.
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redacted-9262 is a form issued by the California Department for certain reporting purposes.
Individuals or entities specified by the California Department are required to file redacted-9262.
redacted-9262 can be filled out online on the California Department's official website or through a designated software.
The purpose of redacted-9262 is to gather specific information as required by the California Department for regulatory or compliance reasons.
redacted-9262 may require reporting of financial information, transaction details, or any other data specified by the California Department.
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