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Retired Police Association of NSW Inc.
Dear
Sir
I
wish to notify my transfer - TO:
FROM:
Last
Name:
_____________________________________
First
Names: _____________________________________
Partner: _____________________________________
Home
Address: _____________________________________
Suburb: ________________ Postcode: _________
Phone
No: ____________________________________
Facsimile: _____________________________________
Moblie: _____________________________________
Email: _____________________________________
D.O.B.: _____________________________________
Former Reg’d No: _____________________________________
Date
of Discharge: _____________________________________
Signature: __________________________
Dated:
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Enter the following particulars including
addresses and Print