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Form Pre-Appointment Certification Statement for Selective Service Registration Instructions

Pre-Appointment Certification Statement for Selective Service Registration PDF [184.03 KB]

  • This form must be completed if you are a male born after December 31, 1959.
  • Under "Certification of Registration Status", check the statement that applies to you.
  • Sign and date the form.
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Source: U.S. Census Bureau | Human Resources Division | (301) 763-4748 |  Last Revised: April 08, 2013