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P. O. Box City State ZIP Code Employee s Work History provide as much information as known - if necessary attach a separate sheet In chronological order starting w ith the m ost recent period of em ploym ent provide the complete work history of the employee named above. Privacy Act Statement In accordance with the Privacy Act of 1974 as amended 5 U.S.C. 552a you are hereby notified that 1 The Energy Employees Occupational Department of Labor which receives and maintains personal information...

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