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Rule 26 Violation
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First Name: 
Last Name: 
Email: 
Phone Number: 
Gang ID: 
Headquarter Location: 
State: 
Week Sent Away:  
Location Sent To: 
State: 
Please provide information on how often you have been sent away:
Signature:

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Burlington Northern System Federation
119 5th St S Unit 1116
Moorhead, MN 56561
  612-332-7947

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