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FORM 1 Please print or type your name, mailing address, agency name, and position below: is...NV×... 2012 STATEMENT OF 1 FINANCIAL INTERESTS in OFFICE USE ONLY: I LAT NAME FIRST NAME MIDDLE NA ME
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Form 1 is a document used to report information to the relevant authorities.
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The purpose of form 1 is to collect specific information for regulatory or compliance purposes.
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Form 1 requires the reporting of relevant financial and personal information as mandated by the authorities.
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