Appendix B. (Continued) WAIVER, ADMISSION AND AUTHORIZATION

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PENNSYLVANIA HARNESS RACING COMMISSION
HARRISBURG, PENNSYLVANIA
WE
I do hereby acknowledge receipt of Citation No.
, and do waive the hearing fixed therein, subject to the approval of the Commission. All the charges averred in the citation are admitted and you are authorized without hearing to enter a final order.

WitnessSignature of Licensee

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