• Section H: Declaration

    Read the declaration. If it is correct, print your full name and position, then sign and date the declaration.

    Both declarations must be completed if you are a supplier of USM information, lodging the USM statement on behalf of the provider.

    If you are the provider lodging the USM statement, only complete the provider declaration.

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    Before you sign the USM statement, check you have provided complete and accurate information. This statement will be returned to you if it is not signed.

    Last modified: 21 Oct 2016QC 21679