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EMPLOYEE\'S REPORT OF INJURY, EXPOSURE, or MEDICAL CONDITION COMPLETE AND RETURN WITHIN 24HOURS TO: Heather.Grover@maine.govPLEASE USE ADDITIONAL PAPER FOR ANSWERS, IF NEEDED 1. Name:2. Social Security
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The REPORT TO BE FILLED OUT BY EMPLOYEE is a fillable form in MS Word extension that should be submitted to the required address in order to provide certain information. It has to be filled-out and signed, which can be done manually, or by using a certain solution e. g. PDFfiller. This tool lets you complete any PDF or Word document directly in your browser, customize it depending on your requirements and put a legally-binding electronic signature. Once after completion, user can easily send the REPORT TO BE FILLED OUT BY EMPLOYEE to the relevant individual, or multiple recipients via email or fax. The blank is printable as well from PDFfiller feature and options offered for printing out adjustment. In both electronic and physical appearance, your form should have a neat and professional outlook. You may also save it as the template to use it later, so you don't need to create a new file from scratch. All that needed is to amend the ready document.

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