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This form is ONLY to be used if the business operating/doing business within the city limits of Rogers has ceased operations permanently, or moved out of the jurisdiction. A separate form will be required for multiple closed business locations.
I hereby certify that I am not doing business at the above business address and declare under penalty of perjury, that I am authorized to complete this application. To the best of my knowledge and belief, the provided information is true and correct.
This field is not part of the form submission.
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