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C A N C E R GENERAL CANCER QUESTIONNAIRE Agent: Phone: Fax: Proposed Insured Name: r M RF Date of Birth: Face Amount: Max. Premium: $ /year r UL r WE r Term r Survivorship Do you currently smoke cigarettes?

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The IRM Twelfth Edition 92401web versionpub is a specific version of the Internal Revenue Manual used by IRS employees.

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