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Y (see valid Federal Facilities/Codes on right side of form) Employed at Federal Facility on list: Yes Employed by contractor at Federal Facility on list (Hill Air Force Base, IRS) No Contractor Name: Federal Facility Name/Code: Hours per day at facility: Mother Military/Federal Employment Information Military Active duty in Military: No Yes Military: US Military Branch: Air Force Date Activated: Non US Military Air Force Reserve Non US Mi.

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