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Get and Sign Form Rc 1 Ark
On any forms attached) customarily employed by him on work in more than one
jurisdiction.
1. The employer accordingly requests the Arkansas Department of Workforce Services to enter
into a reciprocal coverage arrangement to that effect, with each of the following other “interested
jurisdictions” (in which the individuals named under Item 2 may do some work for the employer,
and under whose unemployment compensation laws they might otherwise be covered):
(a) ____________________________ ...
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