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Attachment B List of Accountable Public Officers - New Applicants

Bureau of the Treasury form for the list of bonded public officers for new applicants

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AGENCY LETTERHEAD

LIST OF ACCOUNTABLE PUBLIC OFFICERS
(FOR NEW APPLICANTS)

NAME OF PUBLIC OFFICER

Prepared by:

Signature over printed name

DESIGNATION

AMOUNT OF
ACCOUNTABILITY

REMARKS
WITH/WITHOUT
PENDING CASE, STATE
NATURE OF CASE)

Certified and Approved by:

Name & Designation of Authorized Officical
 
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