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IA1WORKERS COMPENSATION FIRST REPORT OF INJURY OR ILLNESSEmployer (Name & Address incl. zip)Carrier/Administrator Claim NumberGeneralLARUE COUNTY BOARD OF EDUCATIONJurisdiction208 COLLEGE Report Purpose
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Employer name amp address refers to the legal name and physical address of the employer.
All employers are required to report their name and address to relevant authorities.
Employers can fill out their name and address on official forms provided by the governing body.
The purpose of providing employer name and address is for identification and contact purposes.
Employers must report their legal name and physical address.
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