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Get MoneyGram Request for Historical Transaction History

3 - REQUIRED INFORMATION FROM REQUESTOR: FAX: Email: Date: Reference number if applicable Signature: I authorize MoneyGram International., to release all records concerning transactions I have conducted through MoneyGram for the dates below. I release MoneyGram from all claims, damages, or expenses of any kind resulting from unauthorized use of this information. I certify that I have the authority to release information for this account. .

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