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Form 169 Statutory Declaration for Proof of Eligible Service 2020-2023
Employment Start date m/d/y End date m/d/y Employment status for the periods indicated above Continuous full-time Other-than-continuous full-time of full-time hours excluding any period each year when the member didn t work Example Put 50 for a 10-month employee who works five months. If you fax it do not mail the original. Providing OMERS with your personal information is considered consent for its use and disclosure for the purposes set out in our Privacy Statement as amended from time to...
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