Application For Recognition Of Exemption From The Registration Page 4

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URS Exemption Form
Page 2
WE HEREBY certify that we are duly constituted officers of the organization and that the information
contained in the verification of exemption status is true and accurate to the best of our knowledge.
Signature (Print)
Signature (Print)
Title
Title
Daytime Phone Number
Daytime Phone Number
Date
Date
URS exemption form.doc

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