Please complete this form in its entirity. To ease the review process, please ensure the filename(s) of your documents is named as follows:
Document type_Last Name_First Name_ Certificant Number
(For example: Reporting Form_Smith_John_1234)
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NOTE: You must still submit your signed Rules of Professional Conduct (09-0001F) and your payment by March 1 so you do not incur late fees.