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OPWDD, my designated broker and FMS staff. Signature: Date: of person requesting Start-up Broker services (applicant) or the person signing on his/her behalf 11. Payment To bill for monthly hours, the Start-up Broker will complete a Start-up Broker Monthly Progress Report /Invoice Form (CSS-SUB-07) that includes a brief statement of activities completed on behalf of the person for whom he/she is working. The individual receiving the services or his/her designee.

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