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Brown labor. alabama.gov or christine. dunn labor. alabama.gov COMBINATION SUPPLEMENTARY CLAIM SUMMARY FORM 1. 7 Amount and type of comp paid TTD WKS TPD PPD PTD Death Estate Payment Burial Payment LSP Date Pd Part of Body RTW Did claimant work during this period of disability Ombudsman Yes Date Yes Court CV MMI If so from total days to Days POB Location County Adjuster Title Signature 10/01/2012. COMPENSATION WAS NOT PAID WITHIN 30 DAYS FROM THE DATE OF DISABILITY BEGAN COMPLETE THIS...
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