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1 <br /> SERVICE PROVIDER: Please fill in the spaces and sign in the box appropriate for <br /> your business entity. 3 <br /> Corporation <br /> Afflrma, Inc <br /> [Service Provider's Complete Legal Name] <br /> By: --��% / <br /> Typed/Printed Name: Mi ,hO2, _OWn I <br /> Its: ,,.: <br /> Date: 7/22CEO I b 1 <br /> i <br /> Partnership --- <br /> (general) <br /> (general) [Service Provider's Complete Legal Name] <br /> a Washington general partnership 1 <br /> i <br /> r <br /> By:_ <br /> Typed/Printed Name: 9 <br /> General Partner i <br /> Date: ' <br /> Partnership <br /> (limited) [Service Provider's Complete Legal Name] <br /> a Washington limited partnership <br /> t <br /> By: <br /> Typed/Printed Name: --- <br /> General <br /> _General Partner <br /> Date: 1 <br /> i <br /> Sole i <br /> _ <br /> Proprietorship Typed/Printed Name: <br /> 4 <br /> Sole Proprietor: i <br /> Date: f <br /> I <br /> a <br /> Limited _ <br /> Liability [Service Provider's Complete Legal Name] i <br /> a Washington limited liability company <br /> Companyt <br /> By: - € <br /> Typed/Printed Name: _ _ <br /> fi <br /> Managing Member }I} <br /> Date: i <br /> I <br /> 1 <br /> i <br /> Page 11 i <br /> (Form Approved by City Attorney's Office January 7,2010,updated June 15,2014) <br /> 4 <br /> S <br /> i <br /> t <br /> i <br /> e <br />