Arkansas Dhs Collateral Statement Form

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Forms & Documents Arkansas Department of Human …

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6 hours ago 24 rows · DHS-8512 Risk Mitigation Monthly Form. PDF. 05/03/2019. DHS-8520 General Professional Recommendations Form. PDF. 05/02/2019. DHS-8521 Demonstration Services Plan of Care Form. PDF. 05/01/2019.

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Arkansas Dhs Forms Collateral Statement Free PDF eBook

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Just Now Name of Agency Arkansas Department of Human Services. Department. Division of .. applicant in completing form DCO-95, Application for Medical Assistance. .. collateral information may be obtained to verify statements of the applicant. 016.20.04-004.pdf. Read/Download File Report Abuse. Collateral Statement.

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Supplemental Nutrition Assistance Program

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3 hours ago Arkansas Department of Human Services Division of County Operations . DCO-74 DCO 103 List of SNAP Forms DCO-76 Collateral Statement Sept-18 Used to obtain verification of household composition and/or residence in questionable situations. DHS SHARE Spanish form on DHS SHARE . Order from warehouse : Yes DHS-80 Claim of Lost, Stolen and/or

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Collateral Statement Arkansas Dhs Free PDF eBook

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4 hours ago Collateral Statement Arkansas Dhs Free PDF eBooks. Posted on September 07, 2016. Collateral Statement. SDS 3307 (07/07). Collateral Statement. This form should be completed by the case manager during an interview with a family member or friend who has direct. se3307.pdf. Read/Download File Report Abuse.

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Forms Arkansas Department of Health

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3 hours ago Forms; Forms *NOTICE* Due to the ongoing fight against COVID-19, the Plumbing and Food Service Plan Review section of the Arkansas Department of Health is encouraging plan submissions to be sent electronically via our online plan portal or by Mail or delivery service.

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SNP Print Documents Arkansas DHS Welcome

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(866) 632-99925 hours ago To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]

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Arkansas dhs collateral statement form" Keyword Found

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3 hours ago Collateral Source 4130 Time Limits on Disposition of Applications 5610 Form DHS-0145, Client and Service Data Sheet 5620 Electronic Data Systems ARKANSAS DEPARTMENT OF HUMAN SERVICES Sections 1000-1300 SOCIAL SERVICES BLOCK GRANT PROGRAM MANUAL 09-01-01

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Application for SNAP, Health Care, and TEA/RCA …

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Just Now Arkansas Department of Human Services Application for SNAP, Health Care, and TEA/RCA Benefits This is a combined application for food, medical, and cash assistance. You can answer only the questions related to the program(s) for which you are applying. Please answer all questions if you are applying for all programs. A friend,

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Home Arkansas Department of Human Services

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844-763-01985 hours ago Call the DHS Mental Health & Addiction Services Support Line. Phone: 1-844-763-0198. Available: Monday – Friday, 8 a.m. – 4:30 p.m. Find a Provider In Your Area.

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Court Forms Arkansas Judiciary

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9 hours ago Rule 6-9 Form 1 : Rule 6-9 Form 2 : Rule 6-9 Form 3 : Rule XIV Pro Hac Vice Appearance Information and Payment Form : RULES OF THE SUPREME COURT AND COURT OF APPEALS OF THE STATE OF ARKANSAS, RULE 6 - 6 AFFIDAVIT OF INDIGENCY : Sample Language and Calculation - Child Support (July 2020) Sentencing Order Form

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Employer Forms – Arkansas Division of Workforce Services

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4 hours ago DWS-ARK-201PEO – Leasing Employer Client Status Report – This form will allow you to enter your information and then print the page with your information. Do Not forget to fill out pg. 2 of this form. RC-1-ARK – Employer’s election to cover multi-state workers under the Arkansas

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Forms you might need DSHS

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8 hours ago Statement of Collateral Information (form 14-222) This form is completed by the person providing the information that your case worker has requested. You would complete Section 2, print it out and sign it. The person providing your collateral information would complete Section 3.

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Arkansas DHS Welcome

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5 hours ago Welcome to Arkansas DHS! Please Select a Link to Continue. DHS Home DHS Services DHS UAG Portal.

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Arkansas Department of Human Services

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6 hours ago Arkansas Department of Human Services Verification of Earnings TO EMPLOYER: To determine eligibility and correct benefits for your employee we need the information requested below. This will enable us to ensure that the public funds are used only for the actual and correct benefits to which a household is entitled.

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Collateral Statement OHA/DHS Shared Services Production

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7 hours ago Collateral Statement This form should be completed by the case manager during an interview with a family member or friend who has direct knowledge of the circumstances related to the assistance Seniors and provided to the client. People with Disabilities General information 1

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Arkansas Food Stamp Application Form US FOOD STAMP

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2 hours ago Arkansas Food Stamp Application Form. Arkansas Food Stamp allotment. Each State program has their own application form. If your State’s form is not on the web yet, you may need to contact your local food stamp office to request one. Tell Us Your Experience At Your Local Food Stamp Office. Posted on June 15, 2017 by Admin • 231 Comments.

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Forms Department of Finance and Administration Arkansas

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8 hours ago Home Income Tax Individual Income Tax Forms. Forms. Important information: Unemployment is not taxable for 2020. DFA instructions and forms have been updated to reflect the unemployment tax change. Name/Address Change, Penalty Waiver Request, and Request for Copies of Tax Return(s)

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Arkansas Department of Human Services Arkansas DHS Welcome

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7 hours ago Arkansas Department of Human Services (AR DHS) independence, and promoting better health. AR DHS/Division of Child Care and Early Childhood Education : Mission Statement : As good stewards of the public trust, we will support and advise the Division by ensuring that all Arkansas children and families have access to a safe, high-quality

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Forms Arkansas

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Just Now AR-1100CT Form Instructions: 11/18/2009: Form AR1100-CO Schedule of Check-Off Contributions: 11/18/2009: Form AR1100CT Corporation Income Tax Return: 11/18/2009: Form AR1100CTX Corporation Income Tax Amended Return: 02/21/2018: Form AR2220 Underpayment of Estimated Tax: 11/18/2009: Form AR2220A Annualized Income for Underpayment of Estimated

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ARKANSAS DEPARTMENT OF HUMAN SERVICES v. STEVEN …

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3 hours ago Cite as 2021 Ark. App. 43 ARKANSAS COURT OF APPEALS DIVISION II No. CV-19-62 ARKANSAS DEPARTMENT OF HUMAN SERVICES APPELLANT V. STEVEN MITCHELL Opinion Delivered: February 3, 2021 APPEAL FROM THE IZARD COUNTY CIRCUIT COURT [NO. 33CV-18-77] APPELLEE HONORABLE MAUREEN HARROD, JUDGE REVERSED ROBERT J. GLADWIN, Judge …

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Section V Forms and Contacts Arkansas

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2 hours ago The following is a list of the red-ink claim forms required by Arkansas Medicaid. for Under Age 21 DMS-2633 Certification of Schools to Provide Comprehensive EPSDT Services CSPC-EPSDT Certification Statement for Abortion DMS-2698 Change of Ownership Information DMS-0688 Child Health Management Services Enrollment Orders DMS-201 Child Health

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LOCAL OFFICE STATEMENT OF COLLATERAL INFORMATION

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8 hours ago STATEMENT OF COLLATERAL INFORMATION SECTION 1 RE: The Department of Social and Health Services is in the process of determining the above named person’s eligibility. I would appreciate your providing the information requested in Section 2 of this form. …

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LIHEAP DEQ Arkansas Department of Energy and Environment

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8 hours ago Arkansas LIHEAP offers two types of benefit payments: 1. Regular: this benefit is based on household size and income. 2. Crisis: the crisis benefit is a payment up to $500 dollars that depends on the amount of help a household presents as being necessary. LIHEAP Eligibility in Arkansas is based on both 60% of State Median Income and 150% of

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1088.0.0 DHS PARTICIPANT EXCLUSION RULE 1088.1 …

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2 hours ago continue the practices that caused DHS to exclude the participant. 1088.1.2 Participant exclusion is a serious action that shall be used only in the State's best interests and for the protection of the public and DHS. DHS shall impose exclusion only in accordance with …

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Provider Enrollment Application Packet Arkansas

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501-376-22119 hours ago If you have any further questions concerning this letter, please contact the Provider Assistance Center at 501-376-2211 (local or out-of-state) or 1-800-457-4454 (in-state WATS). Sincerely, Arkansas Department of Human Services Authorization for Electronic Funds Transfer (Automatic Deposit) Name of Medicaid Provider Provider ID # Taxonomy Code

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Form W9 (Rev. October 2018) IRS tax forms

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9 hours ago from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items. 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income.

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Arkansas Department of Human Services REEQQUUEESSTT …

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4 hours ago Arkansas Department of Human Services away, complete the questions on page 2 of this form. If you do, we can determine if you are entitled to receive SNAP (DHS) to get information from other state agencies, financial institutions, employers, federal agencies, and other sources to prove my statements are correct. I understand that if

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Form Finder United States Department of State

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5 hours ago Form Finder. U.S. Passport Renewal Application for Eligible Individuals. Nonimmigrant Treaty Trader / Investor Application Use with form DS-156/I-129. Medical History …

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Forms Arkansas Department of Public Safety

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7 hours ago Forms Home > Law Enforcement > Commission on Law Enforcement Standards and Training > Standards > Forms * Copies of the documents used for verification will be retained by the employing agency and must be available for examination at any reasonable time by representatives of …

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Effective Date: February 1, 2020 Page 1 of 6

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Just Now that caused DHS or the Office of Medicaid Inspector General (OMIG) to exclude the participant. (b)(1) Participant exclusion is a serious action that shall be used only in the State's best interests and for the protection of the public, public programs, and DHS. (2) DHS and OMIG shall impose exclusion only in accordance with this rule.

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Quick Reference Arkansas

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6 hours ago The State waives this requirement in certain areas and applies the personal exemptions granted by Food and Nutrition Service in other areas.) 5. Resources - The value of non-exempt resources cannot exceed $3,500* for households with at least one member age 60 or …

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County Operations Archives Arkansas Department of Human

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8 hours ago Divisions & Offices: Donaghey Plaza, P.O. Box 1437, Little Rock, AR 72203. County Offices: Contact Your County Office

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Arkansas DHS Contact Your County Office

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Just Now Arkansas DHS Contact Your County Office. Send a message to your DHS County Office. Use this page to send a message to your local DHS County Office. You may request general information about available services. You may request a mailed application for Food Stamps, TEA, or Medicaid. You may also report changes in your Food Stamps, TEA, or

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Division of Medical Services Arkansas Secretary of State

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8 hours ago The following is a list of the red- ink claim forms required by Arkansas Medicaid. The forms Specifically Included in the Medicaid State Plan . DMS-693. Early Childhood Special Education Referral Form . Arkansas Department of Human Services, Division of Behavioral Health Services

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Acronyms & Terms Department of Homeland Security

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5 hours ago The DHS Acronyms, Abbreviations, and Terms (DAAT) list contains homeland security related acronyms, abbreviations, and terms that can be found in DHS documents, reports, and the FEMA Acronyms, Abbreviations, and Terms (FAAT) list.

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Arkansas Social Forms to Fill & eSign SignNow

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153 2012-20211 hours ago Get And Sign Beegcom Form. Get And Sign Arkansas Dhs Form Dco 153 2012-2021. Get And Sign Arkansas Long Term Care Application 2007-2021 Form. Get And Sign Ar Elderchoices Respite Form 2009-2021. Get And Sign Blank Criminal Record Template 2012-2021 Form. Get And Sign Were Do I Get A 10 336 Form 2001-2021. Get And Sign Hs 31 C 2010-2021 Form.

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ARKANSAS DEPARTMENT OF HUMAN SERVICES Table of …

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4 hours ago Collateral Source 4130 Time Limits on Disposition of Applications 5610 Form DHS-0145, Client and Service Data Sheet 5620 Electronic Data Systems ARKANSAS DEPARTMENT OF HUMAN SERVICES Sections 1000-1300 SOCIAL SERVICES BLOCK GRANT PROGRAM MANUAL 09-01-01

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LEAPS Arkansas Adult Protective Services

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6 hours ago Race: -- Please Select -- Black or African-American Cambodian Chinese Filipino Guamanian or Chamorro Hawaiian Hispanic Japanese Korean Loatian Native American Native Hawaiian or Other Pacific Islander Other Other Asian Samoan Vietnamese White. *Address Line 1: Lives with client. Address Line 2: City: State:

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SOURCES OF VERIFICATION, COLLATERAL CONTACTS

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9 hours ago If a suitable contact is not available, use another method of verification. If possible, get a signed, written statement from the collateral contact to place in the case file. If this is not possible, place a written description of the contact in the case file, including: . The contact's title, address, and phone number, if available.

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PostClosing Loan Review Spec I Arkansas JobLink

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7 hours ago Review consumer non-real estate and business non-real estate loan files for correct forms, completed forms, policy compliance and regulatory compliance, including, but not limited to the following collateral types: Unsecured loans; Vehicle/trailer/boat/ATV secured loans; Deposit secured loans

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Arkansas Department of Human Services Application for

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855-372-10846 hours ago I know that I must tell the Department of Human Services if anything changes (and is different than) what I wrote on this application. I can visit Access.Arkansas.gov or call 1-855-372-1084 to report any changes. I understand that a change in my information could affect my eligibility.

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REQUEST FOR PROPOSAL (RFP) #0152020 SAFEKEEPING AND

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8 hours ago 2.2.3.4 Monitor collateral levels on a daily basis and obtain additional collateral when mark to market v alues fall below acceptable levels. 2.2.3.5 Collect all interest or other distributions with respect to all loaned securities. 2.2.3.6 Provide a daily report on collateral, identifying daily collateral required and pledged, and a monthly

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Victim's Information Arkansas Department of Public Safety

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501-682-86504 hours ago Arkansas Department of Health and Human Services Donaghey Plaza South, Slot S201 P. O. Box 1437 Little Rock, Arkansas 72203-1437 Phone: 501-682-8650. APPENDIX. Victim Organizations (Non-governmental) Arkansas Coalition Against Domestic Violence

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FAMILY SUPPORT UNIT POLICY MANUAL

FAMILY 170.94.37.152 Show details

9 hours ago Arkansas Department of Health and Human Services Division of Child Care and Early Childhood Education P.O. Box 1437, Slot S-145 quality of child care for families in the state of Arkansas. Further goals include assisting families in as well as the State Contract and Grant Disclosure Forms (State Forms F-1 and F-2). If a provider that

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DHS BACKGROUND STUDIES, DISQUALIFICATIONS, AND SET …

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4 hours ago DHS Background Studies, Disqualifications, and Set-Asides Page 7 (described on next page), applicants can request a reconsideration. Depending on the applicant’s risk of harm, as determined by the Commissioner of Human Services, the applicant may be allowed …

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What are the forms for the Arkansas Department of Human Services?

Forms Title Posted Date DHS-8504 Start Service Form 05/10/2019 DHS-8505 Informed Consent 05/09/2019 DHS-8506 MFP Assessment and Personal His ... 05/08/2019 DHS-8507 Checklist of Clients Rights For ... 05/07/2019 19 more rows ...

Who is the Secretary of Human Services in Arkansas?

Together we improve the quality of life of all Arkansans by protecting the vulnerable, fostering independence, and promoting better health. Cindy Gillespie serves as the Arkansas Department of Human Services (DHS) Secretary.

Where to send provider enrollment packet in Arkansas?

P.O. Box 8105 Little Rock, AR 72203-8105 All dates, except where otherwise specified, should be written in the month/day/year (MMDDYY) format. Please print all information. This information is divided into sections. The following describes which sections are to be completed by the applicant: Section I - All Providers

How to claim unemployment insurance in Arkansas Division of Workforce Services?

DWS-ARK-236 – Report to Terminate Account – This form will allow you to enter your information and then print the page with your information on it. DWS-ARK-237 – How to Claim Unemployment Insurance (Employer Workplace Poster).

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