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I hereby authorise Citizens Advice Richmond to correspond and take direction from , of in relation to my case. This includes authorisation for all processes relating to applications, reconsiderations, appeals, disputes, negotiations and representation regarding:

These authorities include Special Category Data, for which I authorise disclosure of:

Health Condition . Ethnicity . Religion Sexual Orientation . Trade Union Membership

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20th July 2021 7:42 am BST

3rd Party Auth Uploaded by Bradley Johnson - Advice@citizensadvicerichmond.org IP 86.14.100.67