| Document Date: 2012-09-13 01:12:15
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Company MURRAY STREET NURIOOTPA SA / Nuriootpa SA / THE COMMUNITY CO-OPERATIVE STORE (NURIOOTPA) LIMITED / Store (Nuriootpa) Ltd / / Currency USD / / Facility Community Co-operative Store / / IndustryTerm goods or services / / Organization CCS / / / Position Privacy Officer at the address shown above / PROPRIETOR / CO-OPERATIVE / /
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Microsoft Word - MEMBERSHIP APPLICATION-Rev1.doc