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License Period: January 1, December 31, Name of Name(s) of Principal Business Owner(s): Street Address of Applicant: Mailing Address of Applicant: Phone No. of Applicant: State Sales Tax No. Fax No. of Applicant: Email Address: State of Wyoming Pawnbroker License Number Signature of Applicant Date For City Use Only Required Attachments: o Copy of valid State of Wyoming Pawnbroker License o $100.00 license fee I do not intend to renew this license Signature City of Cody Pawnbroker License Application Renewal New License License Fee Date Paid License No