Form G-28 - Notice Of Entry Of Appearance As Attorney Or Accredited Representative Page 4

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Part 6. Additional Information
Use the space provided below to provide additional information
pertaining to Part 3., Item Numbers 1.a. - 1.d. or to provide
your U.S. business address for purposes of receiving secure
identity documents for your client (if your client has consented
to your receipt of such documents under Part 4.)
Form G-28 05/05/16 Y
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