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D. Code per biweekly pay period. Signature and Title of Authorized Official REBATE REQUEST FORM Fax to Membership Type Name Signature Recruiter Name Recruiter SSN Full-time in the amount of Date Current Address Notes Zip IRS Form 1099 or W-2 will be issued based on current income tax laws by the payer. Date of Birth - MM/DD/YY 7. Office Phone Number Extension x 8. Primary Personal Email Not your government email address Opt Out Email I would like to receive text messages from AFGE. I give...
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