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Date name of defense attorney Law office of defense attorney address citystatezipDear Mr./Ms. Defense Attorneys Last Name:This office represents the above named patient in a workers' compensation
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The office represents form is a document that allows individuals to declare who will be acting on their behalf in an official capacity.
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The purpose of this form is to establish a legal representation for individuals in official matters.
The form typically requires information such as the name and contact information of the individual being designated as a representative.
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