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(Name and Address of Workplace here)Dear (worker name)As required by the Ray Regulations respecting Ray Safety made under the Occupational Health and Safety Act (O. Reg 861/90), section 9, I hereby
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Start by writing your full name in the designated space. Make sure to write your first name, middle initial (if applicable), and last name.
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What is (Name and Address of Workplace here) Form?

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Name and address of refers to providing the full legal name and physical address of an individual or entity.
Any individual or entity who is requested to provide their name and address information.
You can fill out name and address of by clearly writing your full legal name and physical address in the designated fields on the form.
The purpose of name and address of is to accurately identify and track individuals or entities.
The information required to be reported on name and address of typically includes the full legal name and physical address.
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