Document 6BNmgBz2npw6J1Nqn1E223RpE

PERMISSION TO RELEASE DEATH CERTIFICATES FOR AN EPIDEMIOLOGY STUDY State of Indiana This document is intended to grant permission to ENSR Health Sciences, Alameda, California, to release death certificates (and data derived from them) for subjects belonging to the industry-wide vinyl chloride workers study described in the March 1, 1995 letter from Dr. Hasmukh Shah of the Chemical Manufacturers Association and co-signed by Dr. Christian Seigneur of ENSR Health Sciences. It is understood that ENSR Health Sciences will release such death certificates (and data derived from them) ONLY to a representative of Applied Epidemiology Incorporated, of Amherst, Massachusetts, who has signed the enclosed letter to maintain the confidentiality of the death certificates and data derived from them. Edward N. Lutz, State Registrar and Director, Public Health Statistics Name and title of person authorized to grant this permission Edward N. Lutz Signature of person authorized to grant this permission 4/27/95 Date CMA 120616