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TABC Legal Notice Insertion Order

|Legal business name and trade name (DBA) e.g.: Daily Court Review Inc. DBA Daily Court Review: |

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|2. Type(s) of Permit(s): |

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|3. Address: |

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|City: | |

|Harris County, Texas Zip: | |

|4. List names for all Owner(s), Partner(s), or Officer(s) of Corporation/Partnership and title for each (example: John Doe, President; Jane |

|Doe, Vice President; Jack Doe, Secretary): |

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|Submit to Daily Court Review, 8 Greenway Plaza, Houston, TX 77046 |

|Telephone: 713/869-5434, Facsimile: 713/869-8887, e-mail: publicnotices@ |

|Submitted By: |Name: | |

| |Address: | |

| |City: | |State: | |Zip Code: | |

| |Phone: | |Facsimile | |

|Payment By Credit Card - Rate: $150 |

|Circle One: |V MC AE D | |Signature: | |

|Card Number: | |Exp. Date: | |

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