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ELECTRONIC RECORDING AUTHORIZATION

 

 

 

I, _________________________________________________, authorize

                                      (PRINT NAME)

Roger N. Meyer to electronically record meetings between myself, Mr. Meyer and others with whom I meet.  The recording is to create a sound/video documentation of our meeting.  I require the use of this assistive technology as defined in the Americans with Disability Act of 1990 in order to actively participate in discussion and other matters relating to my personal welfare and case management.  As a person with a disability, I require this reasonable accommodation to help me recall the details of our conversations.  All persons participating in these meetings will identify themselves at the beginning of any meeting in their own voice.

 

All recordings made for this purpose are my personal property.______________________________________

                                                                (SIGNATURE)                      

 

 

 

DATE: _____________________________________

 

 

 

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