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Get Ca 16 Form 2023

Orized Official): issue this form concerning medical treatment. I further certify that the information provided above is true and accurate to the best of my knowledge and belief. I realize that any person who knowingly makes any false statement or misrepresentation to obtain FECA compensation is subject to civil or administrative remedies as well as criminal prosecution. ____________________________________________ Signature of Authorizing Official/Date (Month, Day/Year) If you have a disabili.

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