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APPEAL NO. 041917 FILED SEPTEMBER 14, 2004, This appeal arises pursuant to the Texas Workers\' Compensation Act, TEX. LAB. CODE ANN. 401.001 et seq. (1989 Act). A contested case hearing was held on
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Obtain appeal form number 041917.
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Fill out all required personal information such as name, address, contact number, etc.
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Submit the completed appeal form to the appropriate department or individual as specified.

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Anyone who has received a decision or judgment that they disagree with and want to appeal against.
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Appeal no 041917 is a specific appeal number used for filing appeals with the relevant authority.
Anyone who wants to appeal a decision or judgement must file appeal no 041917.
To fill out appeal no 041917, you must follow the instructions provided by the relevant authority and provide all required information.
The purpose of appeal no 041917 is to allow individuals to challenge decisions or judgements they believe to be incorrect or unfair.
On appeal no 041917, you must report relevant facts, evidence, and reasons for challenging the decision or judgement.
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