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Report Request Form

Please complete this form to request a Report. You will receive confirmation from bill.craighead@dss.virginia.gov within three business days.

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format (XXX-XXX-XXXX)  *

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Type of Report Requested (put a check in the appropriate box):

Type of Report Please Select Report Type


Timeframe Requested:

Timeframe Put a check in the box Amplifying Information


Organization or Organizations Requested:  *

Organization Put a check in the box Amplifying Information


Comments: Please provide other details for your report request


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