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Ng (with an original authorizing signature) to the CPR: (Check only one designation type per form) Authorized to submit paperwork for storage, withdrawal and destruction. Specific training is required. 1.13.12.10 NMAC. Pick-up only personnel: Authorized to pick up records at the records center by appointment. 1.13.12.11 NMAC Record liaison officer: STAFF NAME(S) AGENCY CODE AGENCY NAME & MAILING ADDRESS PRINT NAME: CONTACT INFORMATION PHONE NUMBER: SECTION/ UNIT: SIGNATURE: E-MAIL ADDRESS.

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