Sample Memorandum Of Understanding Template Page 2

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Contact Information
Partner name
Partner representative
Position
Address
Telephone
Fax
E-mail
Partner name
Partner representative
Position
Address
Telephone
Fax
E-mail
________________________Date:
(Partner signature)
(Partner name, organization, position)
________________________Date:
(Partner signature)
(Partner name, organization, position)
Note: This resource is part of series of materials regarding Ombudsman program and P&A collaboration, visit the
NORC
website
for additional information on this topic.
This project was supported, in part, by grant number 90OM002, from the U.S. Administration for Community Living, Department of Health and
Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their
findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.

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