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Iginator) DLIELC/LEAT 2235 ANDREWS AVE JBSA LACKLAND, TX 78236-5259 5. BASIC DOCUMENT (Title, date, and control number) 6. AMENDMENT (Change no., date, copy no., and control/register page no.) 7. DESCRIPTION OF SECTION(S) AMENDED. (Part, Chapter, annex attachment, appendix, etc.) 8. REMOVE PAGE(S) II. 10. CERTIFICATE OF RECEIPT I acknowledge receipt of document described in item 6. 13. ORGANIZATION AND OFFICE 12. DATE III. 16. 11. 9. ENTER PAGE(S) I acknowledge receipt of removed page.

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