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Info picpammr.com Website: www.picpammr.com PLEASE PROVIDE CORRECTAND CURRENT INFORMATION PERSONAL CPA/PRC No: Date: Sex: PRC Registered Date: Male Female NAME: Last Birthday: Tel./Fax Nos.: First Middle Civil Status: Single Married Widow Separated Mobile No.: MEMBERSHIP AFFILIATION Region: Sector: Chapter: Mother Maiden Name Spouse Name: eMail: Commerce & Industry Education Public Practice Government ( to be determined based on place o.

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