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Agenda Item or Topic Description:
Name:
Title:
Email:
Phone:
512-222-3333
Address:
Representing:
I wish to speak to the Commission
I will be available to answer questions from the Commission
I acknowledge that by signing this document I am swearing an oath under penalties of perjury that the information entered herein and testimony I may give in connection with this official proceeding is true.
Signature of Witness
Date