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ARIZONA DEPARTMENT OF ECONOMIC SECURITY Division of Developmental DisabilitiesLCR1084A FOR ENG (120)Page 1 of 2APPLICATION FOR RENEWAL OR AMENDED HUBS CERTIFICATE For Independent Providers Action
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lcr-1084a application is used for applying for a specific license or permit.
Anyone who needs to obtain the specific license or permit.
The application must be completed with accurate and detailed information as required by the issuing authority.
The purpose is to request approval for a certain activity or operation.
The application may require personal information, details of the proposed activity, and any relevant supporting documents.
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