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Get (for Unexempted Establishment Only)

T in an establishment I .............................................................. Son/Wife/Daughter of ....................................................................... . (Name) do hereby solemnly declare that (a) I was last employed in M/s ....................... ................................................................................. . (Name & full address of establishment) ........ ................................................................................. . .

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Fill out (FOR UNEXEMPTED ESTABLISHMENT ONLY) within a few minutes following the guidelines listed below:

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  5. Add the date.
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