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Get MA CSC 665

Es  No  Details of action taken (sentence, length of suspension, amount of fine, etc.) Yes  No  E. Safety Awards Have you ever received a safety award? Yes  No  If yes, give details, including date received Have you ever received a citation for safe driving or for being a safe worker? Yes  No  If yes, give details, including date received If you had more than three traffic violations or two accidents within the last 5 years, provide the information requested in B .

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