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LONG TERM DISABILITY CLAIM FORM EMPLOYEE STATEMENT Instructions for completing the claim form: 1. Complete all applicable areas of the claim form. 2. If you are the Authorized Representative, include

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1. Start by reading the instructions carefully to understand the form's requirements.
2. Gather all the necessary documents and information needed to complete the form.
3. Fill out the personal information section accurately, providing your full name, address, contact details, and any other required information.
4. Follow the form's format and instructions while answering each question or section.
5. Ensure you provide the correct information and double-check for any errors before proceeding.
6. If there are any specific guidelines or additional instructions mentioned in the form, make sure to follow them accordingly.
7. Review the completed form thoroughly, making sure all information is accurate and complete.
8. Submit the filled-out form as directed, either through an online submission or by hand-delivering it to the appropriate office.

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1. Anyone who is required to fill out a specific form as requested by an organization, institution, or government agency.
2. People applying for various purposes such as job applications, government benefits, loans, licenses, permits, or any other official requirements.
3. Individuals who are unfamiliar with the form or its specific instructions.
4. Those who want to ensure they provide accurate information and avoid mistakes or delays in the processing of their application or request.

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