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MS 294 Attachment C June 2016 AUTHORIZATION FOR DISCLOSURE OF NONPUBLIC VOLUNTEER INFORMATION I, print name hereby authorize the disclosure by the Peace Corps to: name and contact information of permitted
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i print name hereby is a declaration where you print your name.
Individuals who need to make a formal statement and print their name.
Simply write your name in the designated space provided.
The purpose is to verify your identity and confirm your acknowledgment.
Only your name needs to be reported.
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