Document

See instructions on reverse of VS Form 1-23, Part 5

ICR 202107-0579-002 · OMB 0579-0440 · Object 113194000.

Document Viewer [pdf]

Status: The document is viewable, but some background extraction is still pending.

Queue: Repair is in progress, but the document is still incomplete and remains in the worker queue. (priority 70 · next 2026-06-30 13:35:17)

Download: Source copy (pdf)

Primary: pdfSource: text/html
Loading document viewer…
Document Metadata
File Typetext/html
File TitleSee instructions on reverse of VS Form 1-23, Part 5
AuthorKhbrown
File Modified2021-07-14
File Created2012-12-12
Conversion Statepartial