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Authorization for Written/Audio/Visual Records
Download Acrobat version - clearance.pdf I, the undersigned, authorize Veterans Affairs Canada to publish excerpts, make photographs, films, audio and/or video tapes as specified. This material may be published for medical, scientific and/or educational purposes. _____________________________________
Use of material: Source/Credit Line (where applicable): The following restrictions apply: This authorization remains in effect until I or my authorized representative advise Veterans Affairs Canada, in writing to terminate the agreement. ______________________________________ ______________________________________ ______________________
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