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Objection to Tentative Order Determining the Percentage of Permanent Partial Disability Compensation Instructions * Print or type all information.
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Document Date: 2014-12-10 11:41:08
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File Size: 41,49 KB
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Organization
Industrial Commission /
OF SERVICE /
/
Position
representative INFORMATION FROM TENTATIVE ORDER Date /
WORKER INFORMATION Injured worker name Claim number Social Security Number Date /
injured worker /
representative /
district hearing officer /
non-attorney representative /
/
SocialTag
Federal Insurance Contributions Act tax
Objection
Law
Economy of the United States
Government
Defense Base Act
Employment compensation
Social Security
Taxation in the United States