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I/O M H No 111244J018 (Extra Jan 2005)United States Department of the Interior National Park Service NATIONAL REGISTER OF HISTORIC PLACES REGISTRATION FORM LFLS form i s IBR use in nominator requesting

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Electronic dshs forms dshs refer to digital forms provided by the Department of Social and Health Services for reporting purposes.

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Entities or individuals who receive funding or services from the Department of Social and Health Services are required to file electronic dshs forms.

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