Smith, Jaclyn
'\.
.
TOWN OF WAPPINGER
TOWN CLERK
SUPERVISOR
CHRISTOPHER J. COlSEY
CHAIRMAN
RALPH HOLT
RE.CEIVED
JAN 2 0 2009
RECREATION DEPARTMENT
20 MIDDlEBUSH ROAD
WAPPINGERS FAllS, NY 12590
(845) 297-0720
TOWN COUNCIL
WilLIAM H. BEALE
VINCENT BETTINA
MAUREEN McCARTHY
JOSEPH P. PAOlONI
January 20, 2009
MEMO TO: SUPERVISOR CHRISTOPHER COLSEY
TOWN BOARD
FROM: RALPH J. HOLT, CHAIRMAN, RECREATION COMMISSION
RE: POSITION OF DIRECTOR OF RECREATION
W.e have been attempting to fill the position of Director of Recreation since August of2008. We
have had two (2) really strong candidates to fill this opening. The one we first selected, Mr.
Richard Bishop, had in our judgment a slight lead Qver the other. We submitted his name to Civil
Service and were toid that he didn't fit their requirements. They supplied us with the nam~s of
five (5) candidates that were on their list of people that did meet the requirements. All ofthese
were contacted and.all decided against applying for the position. I believe they expected the
position to be full time and to pay much.more than $15,000 per year. .
We then requested Civil Service take another look at Mr. Bishop. We and Mr. Bishop tried to
convince Civil Service that we were confident the job could be well handled by Mr. Bishop'. This
brought about some talk between Civil Service and Mr. Bishop. Unfortunately we did not close
the differences between them and ourselves. The net result is Mr. Bishop has requested his name
be withdrawn from those.seeking the position.
We are not happy about how this ended, however, we must proceed as we do have another
candidate. The person we have, Ms. Jaclyn Smith, is an excellent candidate. She has grown up
in our program. She has been a camper, a counselor, a park director and for the last two years has
been second in charge of our Summer Camp Program. She graduates from college this coming
May and as you can see from her resume is an excellent choice. We have complete confidence in
her ability and request Town Board approval, so we can proceed. Civil Service would support
this move providing she take and pass the Civil Service test for this position sometime early in
the performance of this job.
We request your approval. We can set up and interview between the candidate and the Town
Board at your discretion.
f~,. ir~j-
Ralph J. Holt, ~nnan,
Town of Wappinger Recreation Commission
RJH:eam
Ene.: Resume and Civil Service Application
OBJECTIVE:
EDUCATION:
CERTIFICATIONS &
TRAININGS:
WORK EXPERIENCE:
2006-Present
2001- 2005
12/2005 - Present
09/2003 - 2006
9/2001 - 6/2002
2002
ABILITIES &
INTERESTS:
REFERENCES:
Jaclyn E. Smith
49 Scott Drive
Wappingers Falls, New York 12590
845-632-3374
Jackie022280@yahoo.com
To obtain a position working with children and people.
Mount Saint Mary College, Newburgh, New York
Major: Hispanic Studies
Certification: Elementary Education and Special Education 1-6
Anticipated Graduation: May 2009
Dutchess Community College, f)oughkeepsie, New York
*A.S. degree in Liberal Arts and Sciences: Childhood Education (2005)
First Aid & CPR certified, American Heart Association (2005-12/2008)
Basic Training Series For School Age Child Care
Summer Plaveround Director
Town of Wappingers Recreation, .wappi,:,gers Falls, New York
Plan and manage five camps:
- Interview, hire, and train camp directors and counselors
- Order and distribute first aid, arts & crafts, recreation qnd cleaning supplies
- Oversee dire,ctors' and counsel,ors' duties in dailY,activities, and behavior
management
-Participate in field trips, arts and crafts, recreation and first aid.
Area CamD Director
Town of Wappingers Recreation, Wappingers Falls, New York
-Planned, managed, disciplined, and participated in daily activities such ..S field
trips, arts and crafts, recreation and first aid.'
-Supervised, guided and provided 'leadership to counselors and campers
Substitute Teacher
, ,
Wappingers Central School District, Wappingers Falls, New York
-Implement teacher's lesson ,plans, manage behavior,and provide safe
environment
Youth DeveloDer. After School Proeram
YMCA of Dutchess County, Poughkeepsie, New York
-Develop and implement lesson plans. Interact with students academically and
socially. Discipline and provide safe environment for children.
Teaching Assistant
Wappingers Central School District, Wappingers Falls, New York
-Assisted teachers, and students in everyday routines
-Supervised class when teacher was not present
Girls' Softball Coach
Wappingers Central School District, Wappingers Falls, New York
-Implemented sportsmanship,
-Taught the importance of team work
-Developed players skills to fullest potential
Languages: Basic Spanish
Travel: Study Abroad program in Barcelona, Spain
Athletics: Softball, Baseball, Skiing, Volley Ball, Field Hockey
Available Upon Request
M4lL OR L}ELIVER TO:
Dutchess County Personnel Depariment
County Office Building
22 Market Street
Poughkeepsie, NY 12601
County of Dutchess
www.co.dutchess.ny.us
AI'PLICATION FOR
EXAMINATION OR EMPLOYMENT
The New York State Human Rights Law prohibits discrimination in employment because of age, race, creed, color, national origin, sexual orientation. "
disability, genetic predisposition or carrier status, or marital status. Accordingly, nothing in this application should be viewed as expressing, either directly or !i
indirectly, any limitation, specification, or discrimination as to the aforementioned items in connection with employment in the municipal service of the County
of Dutchess.
..........
GENERAL INFORMATION
DUTCHESS COUNTY IS AN EQUAL OPPORTUNITY / AFFIRJvfATIVE ACTION EJVIPLOYER
This application is used for both recruitments and as part of the Civil
Service examination process. Some important requirements:
· Carefully read the appropriate examination or recruitment
announcement before cQmpleting this application. It will inform you
of the required minimum qualifications for the position and provide
y'ou with other -important information.
· Application must be completed in full and printed in ink
or typed. Incomplete 'information or illegibility will result in your
application being disapproved.
· An examination processing fee is currently being charged for
each exam. It is not refundable. Please see the. exam announcement.
for more information.
ADMISSION TO EXAMINATION
-- .
- Depending upon time ~vailable, applicants may be admitted to the
exam without verification of statements and information contained in
their application. When such information must be' reviewed after the
date of examination, candidates may subsequentlybe disqualified and
the results of the examination voided.
If you have not received notice informing you of whether or not you
are to be admitted to the exam by three (3) days prior to the exam date,
call the examinations unit immediately at 486-2169.
SPECIFIC INSTRUCTIONS
AFFIRMATIVE ACTION QUESTIONNAIRE - The information
requested on the reverse of this page is for internal monitoring only.
This information is kept separate from the general application. Refusal
to complete the form will not in any way affect the hiring process or
otherwise subjeCt the candidate to adverse treatment.
ITEM 1 - Enter position title and examination number, if applicable.
The same application may be used for both open competitive and
promotional exams of the same title, but must have both exam
numbers to be processed. Be sure to check the exam announcement to
see if you qualify for the promotional exam.
ITEM 3 - Immediate written notice should be given of any change of
address, name or phone number. Be sure to include the position title,
social security number, and the effective date of the' change. A form
for such notification is available from the office.
~
. I
ITEM 7 - Checking "yes" to any of the confidential questions is NOT I
an automatic bar to employment. Each case is considered and l
evaluated on individual merits in relation to the duties and .~
responsibilities of the position. J
ITEM 8 - Individuals appointed to positions will be required to
provide verification of authorization for employment, pursuant to law.
ITEM 13 - Veteran's Credit -In addition to answering the questions
on this' applicahon, disabled and non-disabled veterans who are
eligible for additional examination credit must submit an Application
for Veterans Credit form. This form is available at the Personnel office
or the examination site, and must be completed, notarized and returned
before the establishment <if the eligible list.
ITEM 14 - Exempt Volunteer Firefighters may be entitled to certain
additional. rights under Civil Service Law. Generally, an Exempt
V olunteerFirefighter is anyone who, after attaining the' age of 18,
serves for at. least 5 years as an active member of an authorized
volunteer,fire company. A certificate will be issued by the fire
company to anyone who meets the standards established under
General Municipal Law. Should you be appointed to a Civil Service
position and subsequently obtain such certification, this office and
your employer should be so notified.
ITEM 18 - Education - Be as specific as possible when completinr,
this section. Copies of transcripts, diplomas or professional licenses
must be submitted with this application if specified on the recruitment
or exam announcement.
ITEM 19 - Work Experience - Be specific in describing work
experience which relates to the position you are applying for. Indicate
a percentage oftime spent on each type of duty. Begin with your most
recent employment, and be sure your description is clear and accurate.
Omissions or vagueness will NOT be resolved in your
favor. Dates of employment should be as specific as possible.
Omission of the number of hours worked will result in no credit for
that work experience.
Include military service experience when appropriate. Relevant
volunteer experience will be considered only if allowed in the
announced minimum qualifications and is verified and fully
documented by the applicant. Part-time work experience will be
prorated unless otherwise stated on the specific announcement.
Cooperative'education positions 01' internships will not be counted if
they also formed part of required education or degree.
(Page 1) version 02/02/07
I
Solely to help us comply with government recora Keepmg, reponmg
and other legal requirements, we request that you please complete this
questionnaire. This form will be removed from the general application
and kept in a confidential location.
A.FJ:I'lRNIA'l'l V E
ACTION
QUESTIONNAIRE
Your cooperation is voluntary
and is much appreciated!
www.co.dutchess.ny.us
Complete for Countv Emolovment Only
Position(s) applied for
" >
j/ i). ('. Y' --I"r'/""" ('Yo"
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:' .' I l..-\... L/'
Male / ~mille'; ( circle one)
"---"
Dateq~l) j {; ?
Name
--. "
)/'In iU' '"'"' ~,.-voo,' 11
"., I.C'_i i r I \.}! I i/"7"i1
i
,~/
How did you learn of this position? ( check one)
Internet Listing .
NYS Job Service Org. for the HandiGapped
Ethnic Organization Veteran'sOrganization
, Relative.or Friend Employment Agency
County Employee Posted Announcement
Professional Organization College Placement Office
O'ther (specify): Old KeCi'?(Lh>::'Jl D /I-e. cfo/r
EEO Office
Examination Hotline
Employee Newsletter
Newspaper Ad
Women's Organization
L'
Please check the one which best describes your Race / Ethnicity.
.' If Hispanic ...
A. Mexican
B. Puerto Rican
C. Cuban
D. Any other Spanish /
Hispanic
Unot Hispanic ...
./
E. White
F. African American
G. Filipino'
H. American Indian (specify
tribe)
1. Japanese
J. Chinese
K. Korean
L. Guamanian. / Chamorro
M. Vietnamese
N. Asian Indian'
O. Eskimo
P.Aleut
Q. Hawaiian
R. Samoan
X. Other (specify)
.
Check any of the following that are applicable.
.
Vietnam Era Veteran (December 22,1961 to May 7,1975)
Disabled Veteran
Handicapped
It is the policy of Dutchess County to provide equal opportunity to all employees and applicants for employment without regard to
race, co lor, sex, national origin, religion, age, sexual orientation, marital status, medical condition, physical and mental disability,
creed, citizenship, HIV, handicap or veteran status, or any other protected status. In addition, Dutchess County has an Affirmative
Action program which creates equal opportunity for all personnel to be chosen by merit and fitness, in accordance with Civil
Service Law.
(Page 2)
Dutchess County General Application (seepage I for specific instructions)
1. Title of Position
,") j.
/\0, C', V _, .L -/ {(c,n. :
Exam Number(s) (if applicable)
www.co.dutchess.ny.us
. . /",;'"
2, Social SecurIty Number: 'J -' t:'
- 'f:?
~ '''i ~! i'
- ~-) -" '-r ;'-';
3.
i...- . i'\ ..."
\{.{-'~ j";~'\/ \
Last Name
L~ C"1 ":<M,.-i~'i rt-
....
{'"'or .
Initial
.,......-r;
~ J :} (:) 'J n
First Name
_ ' J
, )njP '-
Address
'Ii
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, )'it~~i1" _~~}~;:' ~'~
( 'r: 1-., ...., . i- - ...,.") c> '
\ ,-k .; ,I ,-:_/..' "'./'_ .. ~,;
. -r~\j "'\,j ; ..") :~~lC:'
State Zip
( (?,;,..;~....) (~') ~\.3 .. :-1: .~.. ~_ i~
Evening Phone
'" Day Phone
4, State your permanent legal residence for each of the geographic
areas below, indicating the length of continuous residence to date.
Village ofWappingers Falls resident~ should also include town.
Area Yrs/Mos
. I,' ," L' " ll...l II
V\j(t(p,nJ~~~nlY:':'( ;i(~!-:)! ",' i I:C.~~
-fr..':.,.Jy'Ii.'!: IA./Ii!'{.,m;-.: f.~' :J ~ Y tUY )
n, 1...),-(' ~~ J ~:.~t._., J .J R 'l~)!( ('r.:i,,":j
<"'iI ),7{! -' "(,/'t... '~l \:r d .U:.w)
" . - r /
,5. If y 011 .1re under 18 years of age, can you provide proof of your
eligibility to W'ork? Yes _ No_
School District
Village/Town/City
County of
State of
.6. If the position you are applying for has minimum or maximum
,age limits (see announcement), please enter your date of birth:. .
, JK') - ,..., i;"')~;'F,
Month ~ Day' ,Lei- Year 6M.L
7. Check the appropriate line to the right of each question.
Yes No
A, Have, you ever been dismissed from
\ work for other than lack of work or funds?
; B. Have you ever been convicted of any
r;~ime (felony or misdemeanor)?
C. If you served in the Armed Forces of
~:\~, United States, did you receive a
dishonorable discharge?
D, Have you surrendered a professional
license or had it revoked?
E, If you answered "Yes" to any of the
above, have you filed specifics with this
office within the last 4 calendar years?
F, If you answered "Yes" to E above, do
you have any new dismissals or convictions
that were not reported to us?
J
./
1-.1/ /r
~
(<JIlt
;wil it ~
If you answered "No" to question 7E or "Yes" to 7F, a Confidential
Investigative Questionnaire must be submitted.
8, Are you currently a U.S. citizen?
Yes
j
/
v
No
If':No", give alien registratiDn number:
For Office Use On Iv
Approved
Conditional
Disapproved
Fee Paid
Waiver
9. Have you ever served in the Armed Forces of the United States
on a full-time active duty basis other than active duty for training
purposes? Yes No /
If "No", omit questions 10 through 13, If "Yes", refer to
V eterans Credits instruction sheet, available upon request.
10. Did you serve in the Armed Forces of the United States during
any of the following periods? Yes_ No_
A. December 7, 1941 to December 31, 1946
B, June 27,1950 to January 31,1955
C. February 28, 1961 to May 7, .1975
D. August 2, 1990 to "end of such hostilities"
E. U.S. Public Health Service: July 29, 1945 to December
31, 1946, or June 27, 1950 to July 3, 1952
11. Did you .receive an expeditionary medal for any ~f the
following conflicts?' , . Yes No_
F. Lebanon - June i, 19S3 to December 1,1987
G. Grenada - October 23,1983 to November 21,1983
H. Panama - DeceLnber 20, '1989 to January 31, 1990
12. Are you classified as: (Check apprqpriate)
A non-disabled war veteran,
A disabled war'veteran
13. Since January 1, 1951,:have you used additional credits as a
veteran for appointment to any position in the public employment
of New York State or any ofits'civ.i/ divisions?
Yes No
14. Do you posses~ certification as an Exempt Volunteer /
Firefighter? Yes No_
15. If you have been employed by the County of Dutchess or by
any civil division therein (city, town, village, school district or
special district), please state location(s) and dates:
Location:
Dates:
16. For examination purposes only:
Indicate if you desire accommodation because you ...
... cannot be tested on the announced exam date due to a
conflict with a religious observance or practice.
... are a handicapped individual and require the
following assistance or accommodations:
(Page 3)
Exam Fee Waiver Request
All examinations offered by Dutchess County currently require a non-refundable processing fee. This fee will be
waived in accordance with Civil Service Law Section 50.5(b) for candidates who certify they are unemployed and
primarily responsible for the support of a household, or who are receiving public assistance.
Yes No
~
./'
~
/
"
"
-
I am unemployed, primarily responsible for the support of a household, and cannot be
claimed as a dependant on another person's tax return.
I am currently receiving Supplemental Security Income (SSI) payments.
I am currently on Medicaid.
I am currently receiving Public Assistance (Temporary Assistance for Needy Families/Family
Assistance or Safety Net Assistance). Case number: (must be entered)
I am currently certified for Job Training Partnership Act /Workforce Investment Act
programs.
I affirm that th,e inf~rmation ,I.\hc;ve ~r.o:,ided is true under the possible penalties of disqualification andpe..rjury.
Signature. .::..o...cn11cLnu'-th . . . Date q/ nioi(
: 1 ' I !
./
SuppH~mental Information Requir~d by New York State Law
Section 50-b of Civil Service Law requires all applicants for examination be asked the following questions:
Have you any currently outstanding loans made by or guaranteed by
New York State Higher Education Services Corporation?
If so, are you presently in default on any such loan?
'Yes No
../
- ---
../
- ---
Affir~ation and Authorization to Investigate and Release
The undersigned applicant hereby afflrms that the statements made on this application and any attached papers or
documents are true under the penalties of disqualification and perjury.
The undersigned applicant hereby authorizes the Personnel Department of the County of Dutchess or its agents to
investigate matters necessary for the verification of the qualifications of the applicant. Such authorization shall
include the right to examine any and all records, files, histories or other information relating to the applicant in the
possessIOn of any federal, state or municipal authority, corporation, agent or person. Furthermore, such
investigation may include a criminal background investigation, which would require a fmgerprint check, to
determine overall suitability for employment. Failure to meet standards for the background investigation may
-result in disqualification. The applicant voluntarily releases from liability all persons or entities supplyin.g or
collecting such information. ,
d. ~ . ,0"', i\ . :--t--}n,
Signature \:. ClCJJ....rf i . ,l c\:n^,)../'" 1
(' .
Date
q!ID-lo'K
. j
Page 4
.
Name
Address
17. LICENSES
Trade / Professional
Driver
18. EDUCATION
AND SKILLS
College, Trade or
Technical School /
Special Courses /
Continuing
Education
High School
Keyboarding
Computers
Languages
.19.'\vOf{(('.::;';:...,...
~xrEiUENCE\~'rc'
Length of Employment
o/Yr Mo/Yr
From LQ ~ '1[0 LLi/ru,t-
Hours pe :Week
)J,":,
-1-( ..
Earnings
/11';'-' '1 I (J,:''- h.W
Title , J
~. ~. I
UtJ"Ifnl.r {/('.!J"li~v/!:J
1{pe Of"Busin<~.ss 4, i . e......1
~<ec.r<L.o_ he,')']
,~.upervisorJ ;
,x.J:;ff U\':/'le- Y
Supervisor's Title i .
1ft },?!1 hr:'n I), rOdr)'"
(Page 5)
Dutchess County General Application (Complete in full- attaching a resume is not sufficient)
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Position / Exam
Phone (day)
Phone (evening)
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Title I Issuing Agency
License Number
Original Date of Issue
Expiration Date
/
Do you have a valid license to operate a motor vehicle in New Y ork? Yes ~ (Class ~ No
Name I Location
Dates
Attended
FIT
or
PIT
# Yrs
Major I Type
of Course
# of
Crds
Degree Earned I Date
A warded
. ", . /""-:. j
Name of School / Issumg Agency I\~"j~ I (
Add ". - '. f~ - 1,' I
ress '. (;/' {""J ,'; ~i i ('1,
Graduated?
I
Yes
No
Fll!'; f'"k.' 1.,Jy!,C
j. Indicat~ Equivalency Diploma Number if Applicable
Indicate Last Grade Completed
Indicat,e typing / keyboarding experience and whethe.r from work, training or both: '1'- h1..t/ <--
f /':[ ('"1 ')' ;(J. ':, -{' {..".11/~, ((I:U +~" +- t " .?.., .;. '. (':i<> " _I "U, C'~...,.., I'"J(,., '<U'_> (',rv:1
. ' '.. '. . +,,//"1',,;\,
.. '. . .J
Indicat~ program experience in the following types of software and whether from wo~k or training:
word processing , -1 \ crnx'jj2+ 1 '':''- rd f~i" nO: '.4> r j' },-5,;" P{)./\:.:r5 (;-:";.:l;;r,
d h. ) '", - . :",-J
sprea s eet, ir,n '-.',1-'1"1,' ":i':' f-r."'c:l?"',,
database management '
other
H, '.r~0S(' C. ,t.
f). ~.'... \. L,r" I': ~"'\.__ ". ~/.'_'r r }i/"~ (',,~.
Ill' ., ,>?.v pt,.,,,,\, I_.C ;, 11/\..'r.., ,..1,."),,
~ "~" " . '" I ,'. _ '
r..lt.:!:. :::.hfr;..(JCy-v fer (,It;,;;.;
Indicate languages other than English and general level of ability in spt(aking, reading and writing:
<" ., b . ". I . , , I .. .
. )f"\ h f ~l h ,_ ,,'1 <; i C"J pi7 0.. (~h:} r ,f\r]r ~~) 'c hd !J,.:.,[ 1 n 'rj ,
List most recent experience first. Attach additional sheets if necessary. A resume is not sufficient.
Check to indicate you do not wish your present employer to be contacted at this time.
Firm Name Address. ,
fO\.0(\ ;,;.t:- \\JCfplrlc.l': f..s Rc..(j;([.,I':'L.Y) Jo H'\ ddt~_ f?v.sh Rd, ktL(F}i nC)<-./L3 j-:;:..{IS;j(~>i-(,J6
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Duties (indicate % oftime for each) ,:- ()
hv'c
',,' Irif, rJ-1..(' f/
,-
19. WORK EXPERIENCE
(Cont'd)
(Attach additional sheets if necessary, following this format. A resume is not sufficient~{ QU
must indicate months and hours worked per week to receive credit for work experience.)
Length of Employment Firm Name: , " ,4
.. MolYr MolYr i,''';''2/.'(;tOf1Ct:.!-F?) (Qj}f7(:""l
From:' .:- To: i"" 'J.,i~(, '~1:J j' ('I.,,'"
.r. J I.:.,.J' _ ~r '.,.....'" . / f
Hours per, Week:__ /
.;.)()-.:, 'J
Eaktrn in s: It ~ -. ,.,;:)
_ ~ . ." . ..i t.O...1 If') .
, , -",,),,> ."Ii ,,~,,;
Title: ' .' f' i-, J-,
1~yr.'2t':.. (:,(lJ'('f Di (:.2 c.~,-
Type of Business:
'L - r't, , ."
l ' 'YY\Y'I..'.LY l ..1.-1't.-(-'
s~ervlst2: , .
S' P,' '1:' Itk c.:<..n-'\p
RPervlsor s Title: ~) L. '
<eC"yQC\.h.Y! ,I. r~(td
Hours per Week:
;::),I,. ,')0
Ea1nt:' 'I,
, /) -:), .Le (/" y- (JC-Y
T,.i..t1e' "
..)lil6h /ut?...-f',:j 'th.::!"
},Yh of Busmess:, /
SC d Di5rr~1 C:r-
Supervisor: ' I ,
.\:kve n Schucc~,
~(;;:;~9r's..Title:
Hours per Week:
/"7-,,~r
Earnings: '
/I Jd...'). '1 ():' /1" h:.1,..I.r
Title' I
~d..,';'h Dc 'v\~/o p" r
y,pe of Business .
4/-k..r sdr:;J P'2.c/ir<1in
Sr);rvror: . . '/
J v: a Fi.;lmiLY
swervi~;ts Title: " '
( (Y'\('; j(,(lk:Y(Jt,khLd
Firm Name:
T2.,..:-n c..f~ Nu./f". j~':':i.')
/J.,:;'" :r.<J ,,} ~j-, (,:~,'-I
Address:
...... - J./.' " , ("\.' <;/),~ ~_
w~O /tu:_;C:l ()...)Cl)~..'-d-\ J' "--~....
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Duties (indicate % of time for each)
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(...., ;(1
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Address:
/'-1 ie_v'] (.c,"{"'):",) /<'!d
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Firm Name: " I
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