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Commission John E. Fogarty Judicial Annex 24 Weybosset Street, 3rd floor Providence, RI 02903 (401) 222-4942 FULL NAME: PHONE# RI ATTORNEY ID# ADDRESS: FULL-TIME MILITARY ATTORNEY: yes no SWORN IN DURING THE PREVIOUS REPORTING YEAR yes no This form will not be accepted unless completed in full, legible, and certif.

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