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NOTICE TO EMPLOYEES CONCERNING WORKERS COMPENSATION IN TEXAS COVERAGE: Effective on effective date of certificate name of employer has been certified by the Texas Department of Insurance, Division
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Certification is typically provided by a professional or authorized entity.
The individual or entity responsible for the information being certified.
The certification form must be completed accurately and signed by the certifier.
To confirm the accuracy and validity of the information being certified.
All relevant and required information as specified in the certification form.
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