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<br />AUTHORIZATION FORM FOR VACATION LEAVE DONATION <br /> <br />I , hereby release to the City of La Porte my name, <br />and authorize the use of my name, as may be required under applicable Federal <br />regulations, including but not limited to RIPP A law, for purposes of my participation in <br />the La Porte Vacation Leave Donation Program as a recipient of donated vacation time. <br /> <br />Signature <br /> <br />Date <br /> <br />1-04-06 <br />