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Special Power of Attorney (POA) for PERS
Section B: Attorney-in-fact information
Section A: Applicant information
(Type or print clearly in dark ink. Illegible forms could be returned to you, which could delay your request.)
11410 SW 68th Parkway, Tigard OR 97223
Mailing Address – PO Box 23700, Tigard OR 97281-3700
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