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CONSENT TO ACT AS PUBLIC OFFICER
________ (ACN................................................)
The Director
________
________
To the Director,
Full name: ________
Date of birth: ________
Tax file number: ________
Address for service of notices:
________
SIGNED BY ________ on this........................ day of............................................. 20...........
..................................................
________
In the presence of:
................................................
Witness Signature
................................................
Witness Name
................................................
Witness Occupation
................................................
................................................
Witness Address
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