Handle with Care Registry

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I verify that the facts set forth in this form are true and correct to the best of my knowledge or information and belief. This verification is made subject to the penalties of Section 4904 of the Crimes Code (18 Pa C.S. §4904) relating to unsworn falsification to authorities.
This submission is only valid 6 months after the submitted date. You will need to reapply within 6 months.