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Aoc Sj Form
For this month: ________
Court
Division
Reporting Month: ______________
ASSIGNMENT
Reason*
Further Action Required?
If yes, please explain.
Total days worked for current program year: ________
I, __________________________________________________________, certify the above is true and correct.
__________________________________, 2_____
____________________________________________
Date Retired Judge’s Signature
Remit To: Supreme Court of Kentucky 700 Capitol Avenue Room 230...
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