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Safely and Buildings Ili <br /> 201 W Washington Me,*Aux <br /> Po Box 7082 <br /> difa flson VKKI 53707 <br /> Plane: (608)2614500 <br /> TTY: (608)26447_7? <br /> Fax: (602)261.0592 <br /> PkTR XC1C DONALD KAL$CHEUR <br /> 34: NEWBURY CIRCLE <br /> MADISON WI 53711 • <br /> This is your Certification,license, or Registration Card. <br /> Id: d+ <br /> 930407 <br /> PATRICK Is • ,rz o . <br /> CardilesNoss. or aeglirtnelimi Expires <br /> POINTS - RplWado► 0KY27109 <br /> I � <br /> Wisconsin Department of Commerce M <br /> 'UE Y a <br /> Cut sround the card to remove it. Sign the card. <br /> The card should be signed by the spplicanrt. If denied,you may apply a protecuive plastic laminate(available at some <br /> stores)to the card. Present the card to whomever requests proof of imtainoe- <br /> This card should indicate other Department ofComorerae certifications.iioemes.or ryas cnrreadY held. Destroy <br /> all previous ands that have acatification,lioeo n,or registration dory which also appestat on this rand. Please <br /> review dies specified on the and. If errors or dire enciec are found,Place contact the Orstomer Setvice Center <br /> (CSC),606-2614500. Be pared to give the CSC repreaearatire the Id samba printed on the card. lb CSC should <br /> also be notified&changes in addteaes as they occur. Notification to the CSC of address changes is the responsibility <br /> of the eatifc Lion,license,or registration holder. <br /> A avowal notice will be sent to the last address on file with the CSC at least 30 days before the moriration date of each <br /> certification,liocuec,or union indicated on the card. Renewals are contingent upon oaa$m*ace with the require- <br /> meats specified in Comm 5,Wisconsin Administrative Coda <br /> The Depubnmd d Commerce is an equal opportunity service provider and employer. If you need assistaoce to arc= <br /> services or used arterial is an alternate berm,please contact the department at 6011-266-3151 or TTY 6011-2134-117r. .- <br /> SBD-1 01$3(R iMs <br />