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WestVirginiaDivisionofLabor Building6,Room749B Charleston,WestVirginia25305Phone(304)5587890 Fax(3045583797 http://www.wvlabor.orgEmployeeSwornStatementI,, herebycertifythatIamanexistingor previousemployeeofandIunderstandthatthisstatementwillbeusedbytheDivisionofLabortodeterminewhetheror
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