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Section 1: To be completed by Employee. Please print or type. Unsigned/undated forms will not be accepted. Please fax completed form (pages 1 & 2) to 9197163961 or submit to work unit HR Rep/Designee
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Unsigned and undated forms will not be accepted or considered valid by most authorities or organizations.
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Unsigned and undated forms will not be considered valid submissions for official filings.
Individuals or entities required to submit documentation to regulatory bodies must ensure their forms are signed and dated; failing to do so renders them ineligible.
To properly fill out forms, ensure all fields are completed correctly, include signatures and dates as required, and review for completeness.
The purpose is to ensure accountability and verification of information submitted; unsigned and undated forms cannot fulfill this purpose.
All forms must include pertinent information specific to the filing requirements and must be properly signed and dated to be accepted.
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