Board Of Aldermen - Agenda - 1/2/2020 - P95

Document Date

Mon, 12/30/2019 - 17:44

Meeting Description

Document Type

Meeting Date

Thu, 01/02/2020 - 00:00

Page Number

95

Image URL

To: Nashua Police Department

| would like to designate the following individual(s) as my beneficiary for:

Accrued Sick Leave [_ |

Accrued Vacation Leave |_|

Beneficiary #1

(Name) (Relationship)

(Address)

Beneficiary #2

{Name} (Relationship)

(Address)

(Printed Name)

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