What is reported in this questionnaire may be included in the local board's report to the legal parties to the case.

Although not required, if you would like to submit any additional related documents you may do so below:


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    By the return of this document online, you attest that the information is true and accurate.

    Please call the System Oversight Specialist on this case at the phone number listed in the letter you received.
    Otherwise call our main office at 402-471-4420 for assistance.

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