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Get NYC DOE OP-175 2013

the information give above is, to my knowledge, accurate and complete, and I understand that a willfully false answer to any question contained herein is a Class E felony which shall render this application null and void and may result in loss of retention rights, cancellation of per session employment, loss of pay, recoupment of compensation already paid, or disciplinary action. _______________________________________________ __________________________________________ Signature of Applicant Da.

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