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Get DOS DS-3057 2014

IVACY ACT NOTICE This information is requested pursuant to the Foreign Service Act of 1980, as amended (Title 22 U.S.C. 4084). The primary purpose for soliciting this information is to make appropriate medical clearance decisions. Unless otherwise protected by medical privacy regulations, the information solicited on this form may be made available to appropriate agencies, whether Federal, state, local, or foreign, for law enforcement and administration purpose. It may also be disclosed pursuant.

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