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See Page 2 Section 6 Registrant/Licensee Name and Address as shown on Cab Card or IFTA License Signature of Applicant Print Name Federal ID No* s SSN FEIN etc Registrant Telephone Number Fax Number Hereby appoints the following representative as attorney-in-fact Section 2. Representative. Representative must sign and date this form* See Page 2 Part II Name and Address of person or company being appointed as Power of Attorney. Include name of firm if applicable Telephone Number If appointed repr ...

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