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SOLIDWASTECOLLECTIONDECAL Name: CustomerBusinessName: ServiceAddress: MailingAddress: Date: Phone#: Theannualchargeforadecalis×30.00,renewedinJanuaryeachyear. DecalspurchasedafterJanuarywillbeproratedpleaseseeschedulebelow.

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Start by entering the current date on the top line of the form.

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