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TION DATE (May be "Indefinite") 5. SUPPLYING ACTIVITY 6. RECEIVING ACTIVITY a. NAME AND ADDRESS a. NAME AND ADDRESS b. MAJOR COMMAND b. MAJOR COMMAND 7. SUPPORT PROVIDED BY SUPPLIER a. SUPPORT (Specify what, when, where, and how much) ADDITIONAL SUPPORT REQUIREMENTS ATTACHED: b. BASIS FOR REIMBURSEMENT YES 8. SUPPLYING COMPONENT a. COMPTROLLER SIGNATURE c. ESTIMATED REIMBURSEMENT NO 9. RECEIVING COMPONENT b. DATE SIGNED a. COMPTROLLER SIGNATURE c. APPROVING AUTHORITY c. APPROVIN.

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