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SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. <br /> Corporation <br /> [Service Provider's Complete Legal Name] <br /> By: <br /> Typed/Printed Name: <br /> Its: <br /> Date: <br /> Partnership <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> By: <br /> Typed/Printed Name: <br /> General Partner <br /> Date: <br /> Sole <br /> Proprietorship Typed/Printed Name: <br /> Sole Proprietor: <br /> Date:i [� <br /> Limited �t u'i? p t E e n k v4 fM, L1 L'- <br /> Liability [Se ce Provider's Complete Legal Name] <br /> Company a Wa hin ton 1 mite liability company <br /> By:\ <br /> Typed/Printed ame. _P_C_ 9. 1 <br /> Managing Member <br /> Date: `� — 2c' i-OL0 <br /> Page 11 <br /> Three Party Services Agreement <br />