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Installer/Repair Person Information

Store Information

(Deli, Front-end, etc.)

Equipment Installed or Repaired

Separate Serial Numbers with semicolon ( ; )
Please provide copies of all relevant documents by using one of the following methods:
Email to: weightsmeasures@co.bucks.pa.us
Fax to: 215-348-4570
Print this document and mail it along with copies of your documents to:
Department of Weights and Measures
50 N. Main Street
Doylestown, PA 18901