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Get Application For Authorization To Issue Certification For Health Workers - Uscis

Erwise directed. Statement, Certification, Signature, and Contact Information of the Applicant Select the box that indicates if you filled out this form or if someone interpreted this form for you. Additionally, if applicable, select the box that indicates if someone filled out this form for you. Every application must contain the original signature of the applicant. Sign and date the form and provide your daytime telephone number, mobile telephone number, and email address. Contact Information,.

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