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(-A rV a, a1 r J <br />Mourms ViE4v <br />CITIZEN OF THE E YEAR NOMINATIO�N� pFORM \ <br />Name of Nominee: t f h b <br />Title, if applicable: <br />Address:JiD7' <br />City, Zip Code: x'10 U.nc% V�� MA5511-2— <br />Phone: -78 ( gq'70 : cd -v-' b 3rd __ _33 5' <br />Email: <br />Nominated By: L'.%MVV PvtU L <br />Organization (if any): <br />City, Zip Code: M octYNJs D -- <br />Phone: 7(O 3 J+S 9 - '�-%1 9 Fax: <br />Email: c4_L <br />(Attach additional pages as necessary). <br />1.) How long have you known the nominee and in what capacity? <br />_?' .3Ltt ktp- Iv or Imo-, <br />tvt.iWd Z4 Ulf,U 0- /ZAt-cu ,a, lire <br />U " DP , Icy cwt sf I � <br />i / <br />aA' , ) b Ai " A i9 1'n1d n1114 n , i 'IJ --LA L-A <br />7F�.LL.1 C.ri`%lA/id L4�� �L-IR��i/u- Gt�Ly . <br />