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Customer s Full Legal Name or Business Name 1B. Customer or Business Address Including Zip Code 1C. Home Telephone Number Area Code 1D. Business Telephone Number Area Code 2. SSN or Tax ID Number 9 Digits 3. E-Mail Address 4A. Does the customer want to receive mail by USPS 1E* Other Telephone Number Area Code e-mails via GovDelivery Sensitive Producer or Farm Specific related emails YES NO 5. Producer is Customer of One or More of the Following Agencies. Check Appropriate Agency ies below FSA R ...

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