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Get Lasersonline Refund Of Accumulated Contributions Form

I have attached a copy of my Social Security card and have received agency certification from my most recent employing agency. I hereby acknowledge receipt of the attached multi-page document, "Special Tax Notice Regarding Plan Payments," which explains important tax information, options and effects of this transaction. I certify that to the best of my knowledge, all information provided is true and correct. Member's Signature Date SECTION 5: AGENCY CERTIFICATION I hereby certify that the empl.

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