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Get and Sign Prbs Update Form
Type
Color of Eyes
Color of Hair
Female
Prominent Facial Features (mole,
birthmark, scars, etc.)
Badge Nr.
IF RETIREE
Date Entered the Service
Rank
Date Retired
IF SURVIVOR OR TRANSFEREE
Please indicate below the information about the Principal Retiree
FIRST NAME
MIDDLE NAME
LAST NAME
Badge Nr.
Rank
NAME
Date Entered the Service
Date Retired/Separated
Person/s to be notified in case of emergency / Attorney-in-fact
ADDRESS
QUALIFIER
Date of Death
CONTACT NUMBER
I certify that...
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