Epstein Secrets

so Ca jc If it-Do-O611c") tetrIEkpikk., FOtabiNc.i — VWs 1 ive-SZ, pLAN Name 2. Date of StrItt 3. --Address I the above named person authorise Geoff Brock MP, Member for Frome and his staff to make enquiries on my behalf regarding my representation to the Frome Electorate Office. - O?TUS - cLONYT-r9cr -

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I the above named person authorise Geoff Brock MP, Member for Frome and his staff to make enquiries on my behalf regarding my representation to the Frome Electorate Office. ,or OrTUS*-- cONTPC - verz% Ft c on) or /MR)Rtivlicirl I VON> The consent will expire when the investigation of the complaint is complete. Sig

Pectemzvir.,)c, rosaottNic.4 MEDI C. ft c, II. QS i P3 S3PflN . 1. NOM° / / 2. Date of Birth 3. Address I the above named person authorise Geoff Brock MP, Member for Frome and his staff to make enquiries on my behalf regarding my representation to the Frome Electorate Office. flkFm).6 OtITUS*-- cUn

I the above named person authorise Geoff Brock MP, Member for Frome and his staff to make enquiries on my behalf regarding my representation to the Frome Electorate Office. flkFm).6 OtITUS*-- cUntrAct - veR.1 crerri on) oF inw:DiervirTr-l(24.1 ver\,) sa-rt Orr( The consent will expire when the investigation of the