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Earing Decision/Order Sections 205(a), 702, 1631 (e)(1)(a) and (b), and 1869(b)(1) and (c) of the Social Security Act and Public Law 106-169 (sections 809(a)(1) and 251 (a)), as amended, authorize us to collect this information. The information you provide on this form is used to complete our claims process. Your response is voluntary. However, failure to provide all or part of the requested information may affect the continued processing of your claim. We rarely use the information provided on.

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