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Get Light Duty Form 2000-2024

D injury or illness, and I have attached appropriate medical documentation to support my request. I understand -light duty is not a "make work" situation, it is an accommodation. I understand I may be required to have my work hours changed in order to provide me with work. All efforts will be made to provide work within my craft and salary level that meets my restrictions. _________________________________ Employee's Printed Name __________________________________________ Signature/Date ______.

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