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/ / Signature of Approved MV-283 Lecture Teacher Instructor Certificate Number Date / / ) Student s Client ID Number (if available) To knowingly make a false statement or conceal a material fact in this Student MV-285 Roster is a criminal offense. False statements are punishable under Section 210.45 of the Penal Code. (If multiple Lecture Teachers are employed, only Lead Teacher Signs) Date certificates were issued: From: / / To: / / Telephone Number (include area code) S.

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