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Get Wsib Authorization 2013-2024

is in a position to commit the organization on a corporate level or normally has access to and control of the information to be released (see page 2). By signing below on behalf of the employer/company named in PART A, I authorize the person or company named in PART B, as indicated above on this Employer's Direction of Authorization. Name (print) Signature Title (print) Date (mm/dd/yyyy) 1797A (03/13) Page 1 of 2 Employer's Direction of Authorization Firm File Access Cancelling or changi.

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