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FORM 24: MATERNITY BENEFIT

Regulation 91

NOTICE OF WORK

I,___________ ,wife/daughter of ___________ Insurance No _________________ do hereby give notice that I have taken/ shall take up work for remuneration from ____________________

I have drawn maternity benefit only up to ______________________

Date ____________________

Present address (if changed)____________

Signature or thumb-impression

Local office ____________

 

 

 

 

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