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 Bwc Form R 2 Fillable 2013

Bwc Form R 2 Fillable 2013

Use a Bwc Form R 2 Fillable 2013 template to make your document workflow more streamlined.

Of injury Representative information *You may have only one legal representative (one attorney or one law firm) and one union representative. **Your representative must have a BWC representative identification number prior to being designated as an authorized representative. Representative/firm name* Representative BWC ID number** Phone number Representative street address City State ZIP code Authorization I authorize the above to be my authorized representative. The authorization...
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