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CONSENT FOR RELEASE OF INFORMATIONOffice of Congresswoman Japan Hayes Phone: (860) 2238412 / Website: hays.house.gov Please complete this form and return to: 108 Bank Street, 2nd Floor, Waterbury,

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Office of Congresswoman Jahana refers to the official office held by Jahana Hayes, a congresswoman serving in the United States House of Representatives.

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