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Get T Mobile Exigent Request Form 2018-2024

Y written or typed response to any field will delay compliance. Name of Government Entity: Government Entity Address: City, State, Zip: Government Entity Phone Number: Fax Number: Requesting Officer/Agent Name, Title, Badge, or ID Number: Agent Call Back Number: Agent Email: Supervisor s Name: Supervisor s Phone Number: I hereby certify that I am employed by the above-named government entity and have been granted authority by the entity to determine and declare an exigent circumstanc.

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