Notary Form Perparedness for SAM.GOV Registration

Date

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Signatory

Signatory Name Signatory Title

Entity

Entity Legal Name Entity Legal Address DUNS Incorporation State Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming

Entity Administrator

Is Entity Administrator the same as the Signatory? Entity Administrator Entity Administrator Phone Entity Administrator Address Entity Administrator Email

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