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/20(Office use only)ApplicationFORM 5AMatter No:Application to Register a Commutation AgreementApplicant: Respondent: Filed by: WorkerEmployerSelfinsurerWorker representativeEmployer representativeInsurer/scheme
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Form 5a is a tax form used to report annual income and expenses.
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Form 5a can be filled out online or by mail, and requires detailed information about income and expenses.
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