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Property Claims Associaiton
of the Pacific

2012 Membership Application

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Then fill it out and mail it with your check to the address indicated.


Name  _____________________________________________________________________

Company   __________________________________________________________________

Current Position  _____________________________________________________________

Business Address ___________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Phone __________________________________
E-Mail __________________________________
Fax     __________________________________



Membership dues are based on calendar year, payable by January 30 each year.
Annual dues are $40 if received before March 1, 2012. $50 per person thereafter.
Please return application with check payable to the Property Claims Association and send to:

Michael Diliberto III, CPA
RGL Forensic Accountants and Consultants
100 Bush Street, 20th Floor
San Francisco, CA 94104

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