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Get Employee Statement Form Pdf

I acknowledge that the above statement is a true and accurate representation of this information. Employee s Signature Date Comment OoSP1 Form must be printed for signature on hard copy. SGWCP-2 06/00 NORTH CAROLINA STATE GOVERNMENT WORKERS COMPENSATION PROGRAM EMPLOYEE STATEMENT AND LEAVE OPTIONS Supervisors should provide all injured employees with this form to complete the information concerning the accident/incident and use of leave options f.

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