Document O3pzJZv3q5pn6MV3VaRpg8pNX

3 110R--24--1995 105 39 2028874756 sui ravia 1AK. g HiiiMiiMiMTHirmumMiHiiti iii'tdiim 202 887 4756 FAX P.001 TO COMPANT FAX : Oanafhflrt f^a/nlfiu^> NO. PAGES ;__ L(dudmg cover) : ____________________ DATS = ffn-uau-txir__ : . i Of* from FAX# ; <Hdf__ : 887-S427 DIRECT DIAL 9*033 V S ** 1AR-24--1995 10:38 2028874756 202 887 4756 P.002 PERMISSION TO RELEASE DEATH CERTIFICATES FOR AN EPIDEMIOLOGY STUDY State of New Mexico 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 l, 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. Name and title of person authorized to grant this permission Signature of person authorized to grant this permission Date R&S152849 TOTAL P.002