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Get Download And Complete The ARPA Order Form - American Red Poll ... - Redpollusa

1 CUSTOMER INFORMATION Company Name Date Contact Person Mailing Address Office Phone Cell Phone City, State, ZIP Notes Fax E-mail ACCEPTANCE AND AUTHORIZATIONS PLEASE SIGN BELOW TO CONFIRM YOUR ACCEPTANCE OF THE ATTACHED TERMS AND CONDITIONS. I hereby request and authorize the disclosure of the Test Results for the enclosed samples to Pfizer Animal Genetics identified below. I also hereby agree to indemnify and hold Pfizer Inc. and its subsidiaries harmless for any claims or damages res.

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