I hereby certify I sent a copy of this Tlingit & Haida Court
Notice to the Court on __________ 320 W. Willoughby Ave. Suite 300
to __________________________ Juneau, AK 99801
by mail/email/hand delivery 1-800-344-1432 / 866-532-3558 Fax
Signed: _____________________
My name is (please print) ______________________________________________________.
I am providing Notice to the Court of the following:
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Signature and Title Date
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Mailing Address Phone Number