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I affirm that the information I have provided is accurate to the best of my knowledge. Signature Date Please send this request form to Chris Collings 2nd VP at HCU via inner-office mail Or by postmark to HCU 245 SE 4th Avenue STE A Hillsboro OR 97123 Requests will be reviewed by the HCU Executive Council and you will be notified of their decision. Request Tracking Section Do Not Fill Out Received Date Reviewed Date Employee Notified Date Approved Denied HCU Board Member Signature Last...
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