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Get Ph Afp Pgmc Nr. 1a 2007

ENEFICIARY’S SPECIMEN (IF DECEASED, IGNORE THIS BOX) 2 x 2 picture (Beneficiary) LEFT THUMBMARK RIGHT THUMBMARK I declare under the penalties of perjury pursuant to the provisions of existing laws, that this has been made in good faith, verified by me, and to the best of my knowledge and belief, is true and correct. BENEFICIARY (Signature Over Printed Name) DATE SIGNED (Day, Month, Year) ADDITIONAL INSTRUCTIONS: REQUIREMENTS FOR AFP RETIREE: 1) If the AFP Retiree is still alive: Fil.

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