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Please fax to: (727) 8032094 Workers Compensation Certificate Request Client Information: Date: / / Requested By: Client Name: Client # (if applicable): Phone: () Fax: () Certificate to be Issued
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Start by writing the recipient's name and company on the top line of the fax cover sheet.
02
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The individuals or entities specified in the instructions or guidelines for form 727 are required to file it.
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Please refer to the instructions provided with form 727 for guidance on how to properly fill it out for faxing.
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