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Date of Call: Product/Service Oered: Business/Solicitor Name: Business Address: City, State, Zip: Business Phone: Caller Name,

if provided:

Time:

Date of Call: Product/Service Oered: Business/Solicitor Name: Business Address: City, State, Zip: Business Phone: Caller Name, if provided:

Time:

OR call 1-800-HELP-FLA (435-

OR call 1-800-HELP-FLA (435-

Date of Call: Product/Service Oered: Business/Solicitor Name: Business Address: City, State, Zip: Business Phone: Caller Name, if provided:

Time:

Date of Call: Product/Service Oered: Business/Solicitor Name: Business Address: City, State, Zip: Business Phone: Caller Name, if provided:

Time:

OR call 1-800-HELP-FLA (435-

OR call 1-800-HELP-FLA (435-

Date of Call: Product/Service Oered: Business/Solicitor Name: Business Address: City, State, Zip: Business Phone: Caller Name, if provided:

Time:

Date of Call: Product/Service Oered: Business/Solicitor Name: Business Address: City, State, Zip: Business Phone: Caller Name, if provided:

Time:

OR call 1-800-HELP-FLA (435-

OR call 1-800-HELP-FLA (435-

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