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Get AR ASP-50 2011

2) Witness or Other Complainants: Home Address: Home Phone: ) ( Date and Time of the Incident: Location of the Incident: Details of the Complaint COMPLAINT AFFIRMATION I, __ ___________________________________, do hereby affirm that the foregoing information is true and complete to the best of my knowledge and belief. I understand that any false, misleading, or untrue statements or writings given to any person(s) investigating this complaint may subject me to civil prosecution by the accus.

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