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Billing Notes Signature

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Signed by Inez Johnson
Signed On: August 17, 2023

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July 13, 2023 10:39 am CDT

Billing Notes Signature Uploaded by Inez Johnson - goeforms@gmail.com IP 70.121.87.129