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Click ‘Get Form’ to open it in the editor.
Begin by filling in your *Last Name* and *First Name*. If you have any former names, include them in the designated section.
Enter your *Date of Birth* and the last six digits of your Social Security Number. This information is crucial for identification purposes.
Provide your current *Address*, including street, city, state, and zip code. Ensure all details are accurate to avoid processing delays.
Fill in your *Phone Number* and *Email Address* for communication regarding your request.
Indicate the *Date of Last Audit Request* if applicable, and check the box if you have never requested a Self Audit before.
Review the terms regarding free audits and notarization requirements before signing. Ensure that all information is true and accurate before submitting.
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By signing below, I provide my consent to a CORI check and affirm that the information provided on Page 2 of this. Acknowledgement Form is true and accurate.Read more
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