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LOSS SUMMARY DATA REPORT ITEMIZED LISTING FOR PERIOD ENDING DECEMBER 31, 2006, Page of Name of Self-Insurer ACC FILE # NAME OF EMPLOYEE DATE OF ACCIDENT NATURE OF INJURY AMOUNT TS PAID FOR INDEMNITY
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What is si7a?
Si7a is a form used for filing information about a specific activity.
Who is required to file si7a?
The individuals or entities involved in the specific activity are required to file si7a.
How to fill out si7a?
Si7a can be filled out by providing the requested information in the designated fields of the form.
What is the purpose of si7a?
The purpose of si7a is to report and document details about a specific activity.
What information must be reported on si7a?
Si7a requires the reporting of relevant information related to the specific activity, such as dates, participants, and outcomes.
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