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Get GSA SF 1174 1992-2024

Nses? FINES, PENALTIES, and FORFEITURES are imposed by law for the making of false or fraudulent claims against the United States or the making of false statements in connection therewith. (Signature of claimant) (Date) (Signature of claimant) (Street address) (Street address) (City, State, and ZIP code) (Date) (City, State, and ZIP code) TWO WITNESSES ARE REQUIRED We certify that we are well acquainted with the above the signature(s) of the claimant(s) was (were) affixed in our presenc.

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