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(Address) This is to certify that I, the undersigned, am a representative or employee of the USDA Forest Service; that the charges for the occupancy at the above establishment on the dates set forth below have been, or will be, paid for by the USDA Forest Service; and that such charges are incurred in the performance of my official duties as a representative or employee of the USDA Forest Service. DATES OF OCCUPANCY: SIGNATURE:.

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