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Get Mc 1982 A - Department Of Health Care Services - State Of California

De County Claim File Name Total Actual Expenditures of Services Rendered $ Revised Claim File Name CERTIFICATION FOR SERVICES RENDERED: I HEREBY CERTIFY under penalty of perjury that I am the official responsible for the administration of Community Mental Health Services in and for said claimant; that I am authorized to sign this certification on behalf of the County; that I have not violated any of the provisions of Section 1090 et. seq. of the Government Code; that the amount for which reimb.

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