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Get Canada Form 6a 2004-2024

DISEASE TO EMPLOYER Please answer all questions and complete this report in ink. Incomplete applications may have to be returned resulting in some delay in the processing of your claim. Please ensure that this report is signed and mailed to the WCB office serving your workplace area. This report should be completed by the injured worker if fit to do so. It should never be completed by anyone else for signature by the injured worker. Section 53(3) of the Workers Compensation Act requires that wh.

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