Get the free The undersigned has filed a claim for workers compensation benefits (hereinafter ref...
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The undersigned has filed a claim for workers compensation benefits (hereinafter referred to as the
Claim). The amount and type of information sought pursuant to this authorization will
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8.1
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The form undersigned has filed is Form XYZ.
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Anyone who meets the criteria outlined in the instructions for Form XYZ is required to file it.
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