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In Section 2c, below, of this Security Assessment Affidavit, provide a list of PPS downstream partners who will be accessing DOH Medicaid Data. 4. Affidavit of Personal Responsibility.NOTE: You must complete a SEPARATE CONTRACT AFFIDAVIT for EACH directed experience site and supervisor. ATP Form 15 - Blood Alcohol Analysis Affidavit. Member of the World Professional Association for Transgender Health (WPATH). Member of the World Professional Association for Transgender Health (WPATH). A listing is evidence only that a Private School Affidavit has been filed. Transcript of your test results or equivalent. 8. PHARMACY TECHNICIAN DOCUMENTS: Attach ONE of the following (A, B, C, or D):. Please return all completed forms to: Seminole State College 100 Weldon Boulevard Sanford, Florida 32773-6199. Contact.