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Pacific Academy 10238 168 Street Surrey, BC V4N 1Z4 Phone: 6045815353 Fax: 6045810087 Email: dlutz@mypacificacademy.net Website: www.pacificacademy.netMEDICAL INFORMATION FORM 1. Student Name: ___
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Start by filling out the recipient's name in the designated field.
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Next, enter the street address, ensuring that all details are correct and complete.
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Include any additional address information such as apartment number or floor.
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Finally, include the country name in the last line of the address.

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Address 5 refers to a specific component of a form or document that requires the reporting of particular information related to an individual's or entity's location.
Individuals or entities that are mandated to disclose their primary address or any pertinent address information as per regulatory requirements must file address 5.
To fill out address 5, provide the full address including street number, street name, city, state, and ZIP code as specified in the instructions accompanying the form.
The purpose of address 5 is to ensure accurate record-keeping and to facilitate communication, compliance, and verification processes related to the individual's or entity's principal location.
Address 5 must report the complete and accurate physical address of the individual or entity, including any applicable details that may affect jurisdiction or compliance.
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