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R on the fitting. STATUTORY DECLARATION Registration of Fittings See Guidance Notes on page 2. I, (2) , (1) (3) (company title, e.g. vice president, plant manager, chief engineer) (must be in a position of authority) (4) of (name of manufacturer) located at (5) (plant address) do solemnly declare that the fittings listed hereunder, which are subject to the Safety Codes Act (check one) comply with the requirements of (6) which specifies the dimensions, (title of recognized North Amer.

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