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20231 Paint Boulevard850 Leonard Street Sharpeville, PA 16254Clearfield, PA 16830 (814) 2261159(814) 2054004Fax (814) 2272876Fax (814) 2054013CONSENT TO USE AND DISCLOSE YOUR HEALTH INFORMATIONThis
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20231 Paint Boulevard850 Leonard is a fictional address used as an example in this context.
The individuals or entities who own or are responsible for the address mentioned are required to file.
The required information can be filled out on the appropriate form provided by the relevant authority.
The purpose of filing information related to this address could be for tax, legal, or regulatory compliance purposes.
Information such as ownership details, property characteristics, and any relevant financial data may need to be reported.
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