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PLEASE TYPE OR PRINT LEGIBLY. State Form 12386SELFINSURED EMPLOYER CERTIFICATIONSTATE OF, COUNTY OF, hereby CERTIFY that I Amos(Title)(Company) and that I have knowledge of the workers' compensation
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How to fill out certification i hereby certify

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To fill out certification i hereby certify, follow these steps:
02
Start by stating your full name and contact information at the top of the certification.
03
Include the date of certification to indicate when you are making this declaration.
04
Clearly mention that you hereby certify the information or statement provided below.
05
Write the specific details or statement that you are certifying.
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Sign the certification at the bottom to authorize and validate your declaration.
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Optionally, you can include the name and contact information of any witnesses if required.
08
Keep a copy of the filled certification for your records.
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Note: The exact format and requirements may vary depending on the purpose and jurisdiction.

Who needs certification i hereby certify?

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Certification i hereby certify may be required by various individuals or entities, including:
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- Professionals issuing legal or official documents (e.g., lawyers, notaries, doctors).
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- Individuals making official statements or declarations (e.g., affidavits, sworn statements).
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- Organizations verifying the accuracy or authenticity of information (e.g., companies, institutions).
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- Parties involved in legal matters or contracts requiring certified statements.
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- Government agencies, regulatory bodies, or licensing authorities.
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Make sure to check the specific requirements and guidelines for your situation or jurisdiction.
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Certification i hereby certify is a statement confirming the truth and accuracy of certain information provided.
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Certification i hereby certify can be filled out by providing the required information and signing the document to confirm its accuracy.
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