Masking Requirement Addendum for Certified Businesses

Important: If you have not already submitted your Business Plan, this is not the correct form. Click here to complete your Business Plan. This addendum is for businesses that have already registered and are updating their business plan in compliance with the masking mandate.

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Business Information

Facility Address:

Electronic Signature

I attest that the above information is true. I understand that I must verify the above information.

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