Cargo Bulk Item Order Form

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[b][u]CG-83-1 Form:[/u][/b][large] Form for the Request of Commodity or Substance[/center][/large][br]
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[b][u]Name/Aliases of requesting party:[/u][/b][i][br]
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[b][u]Current Occupation of requesting party:[/u][/b][i][br]
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[b][u]Name/Aliases of providing party:[/u][/b][i][br]
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[b][u]Current Occupation of providing party:[/u][/b][i][br]
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[b][u]Requested Item or Service:[/u][/b][i][br]
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[b][u]Cause for Request of Item or Service:[/u][/b][i][br]
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[b][u]Intended use of Requested Item or Service:[/u][/b][i][br]
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[b][u]Co-signer for Responsibility for Loss or Damage to Object in Event of Loss or Damage:[/u][/b][i][br]
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[b][u]Signature of Relevant Departmental Head if Relevant:[/u][/b][i][br]
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[b][u]Date and Time of Request:[/u][/b][i][br]