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1. REVISION DATE: ___/___/___ MM DD YYYYSTATE OF MAINE WORKERS\' COMPENSATION BOARD 27 STATE HOUSE STATION, AUGUSTA, MAINE 0433300272. WEB FILE NUMBER (if known):CONSENT BETWEEN EMPLOYER AND EMPLOYEE EMPLOYEE3.

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Instructions for completing RB-892 provide detailed guidelines on how to properly fill out the form, which is required for specific tax-related reporting.

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