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DATE OF HIRE: WEST PALM BEACH POLICE PENSION FUND APPLICATION TO ELECT EARNINGS METHOD PLEASE PRINT OR TYPE: 1. a. Name of Participant: b. XXXXXInsert Last Social Security Number: Four c. Date of
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West Palm Beach Police is the law enforcement agency responsible for maintaining public safety in the city of West Palm Beach, Florida.
Certain businesses and individuals may be required to file reports with the West Palm Beach Police department.
The West Palm Beach Police department provides forms and instructions for filling out the necessary reports.
The purpose of West Palm Beach Police is to ensure the safety and security of residents and visitors in the city.
The specific information required to be reported will depend on the type of report being filed with the West Palm Beach Police department.
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FLORIDA revokes ies false 30th xxinsert deposes rata cautioned undersigned foregoing electing Designation supersedes SUBSCRIBED Additionally certify Participant xxx credited disqualify Notary Variable therein EARNINGS Expires supplement Trustees Beneficia

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