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FREEDOM MIX RIDERS CLUB

Complete Name Date of VOR # Position Permanent Address Date of License # / Signature
Member ship Birth Expiration Date

Official Record for SORSOGON Chapter


Prepared by: Noted by: Check by: Approved:

______________________ ________________________ __________________________ GERSON D. MIAS RODERICK L. AYCARDO


Chap. Sec. Chap. Pres. Chap. Admin/ Co. Admin FMRC Bicol Vice-Chairman FMRC Bicol Chairman

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