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It is a form used to report share trifold information for a 12-week period.
Employers who have employees receiving workers' compensation benefits are required to file this form.
The form must be completed with information on the share trifold program offered to employees.
The purpose is to track and report the share trifold program details for workers' compensation benefits.
Information such as the details of the share trifold program, number of participants, benefits offered, and any changes made.
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