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Get Usca Form 81

Au, commission, office or Yes No agency of any kind ever been qualified, terminated or withdrawn? If yes, explain in full. Use separate sheet if necessary. 15. (a) Have you been a defendant in any criminal proceeding in which allegations of fraud, misrepresentation or other dishonesty were made against you? If yes, explain in full and attach hereto copies Yes No of all court documents relative to the disposition of such proceedings. Use separate sheet if necessary. (b) Have you been convicted.

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