Get the free Fill in each item if you are representing an employer or complainant in a Labor
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Date Case File ID or Order to Comply Number Client/Member Represented check one Employer Complainant/Claimant Client Business Name Subject of Client s Claim e.g. minimum wage overtime etc. Representative Information all fields must be completed Organization/Firm Name Signature Title Choose One Attorney Advocate Accountant Other Address Telephone Fax Email Are you being compensated by the claimant Yes No represent me in matters involving my complaint/claim. You have my permission to...
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