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Suitability V Security OPM Form
15b. Signature 15c. Date Signed MM/DD/YYYY PAGE 2 of 18 Name Last First Middle Initial Suffix Social Security Number ADDITIONAL ENTRIES 2b. Only describe Additional Income e.g. gifts inheritances winnings etc. received during the preceding year. OMB Control Number 3440-0001 Expiration date 11/30/2021 FINANCIAL DISCLOSURE REPORT Please Note Section 1. 552a. This information is to be released only to authorized personnel having a need to know for official uses. T Trust Distributions W Winnings P...
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