Document EdpXp6XbaJqmne0bNjzjzLrGV

j t i -j 3 j \j ^, j o r iu * ^ Ai w l r., vi *" f, -- 4 u APR 12 '98 0914** ADMIN 1933 BLDG >17 36 1675 P.4^4 PERMIS8I ON TO RBLEASB DKATi CSRTIFICATBS FOR AIT EPIDEMIOLOGY STUDY Stati i of Indiana This document Is Intended to grant permlMion to ENSR Health Sciences. Ala mods, California, to celease death certificates (and data them) for subject belonging to the industry-wide vinyl chloride worsen study desert ted in the March 1, 1995 letter from Dr. Hasamfch Shah of the Chi mical Manufacturers Association and consigned by pr, Christian Sdnaour of ENSR Health Sciences. It la understood that ENSR Hialth Sciences will release such death certiflcatea (and data derived Grom them) ONLY to a representative of Applied X| ddemlolegy Inca porated, of Amherst, Massachusetts, who has sign 4 the inclosed letter to maintain the confidentiality of the daath certificates and data derived from them. EDWARD N. 1,0TZ, STATE REGISTBAR AMD DIRECTOR OF PUBLIC HEALTH STATISTICS Name and title of person authorised to grant this permission 'Vi j TSignature of person authorised to gcrant this permission Date I Aw ) 4'S . S4 a C CMA 120618 ' I SDH FAX ISDH FAX! fUMBER: 317083-^489 a LSWvTO: -fivn (j j Tbk 57FAX NUMBER: %>2- &n-12. ....................II I o II TOTAL PAGES: ll_^------- 11 (including cover: heet) FROM: INDIANA STATE DEPT. OF HEALTH PUBLIC HEALTH STATISTICS 1330 WEST MICHIGAN STREET P.O. BOX 1964. INDIANAPOUS. IN 46206-1964 NAME: Lu'J'Z^ PHONE: 317/383-6307 DATE: REMARKS: i * ., CMA 120619