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One leaf typewritten on the front side. The document is in good physical condition. The document was laminated. The upper left corner, the upper right corner, and the lower left corner were folded into the laminate. There is a significant lamination-related crease on the left side of the document. There is some moderate fraying along the upper right edge. There is a minor tear hole at the upper left corner. There are two minor tears at the right lower edge. There is some acid-related staining at the upper right corner. There are several textual corrections handwritten in black ink. The document is a carbon duplicate.

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