Form 112A - Affidavit in Support of Request for Waiver of Filing Fee Under § 11C

Department of Industrial Accidents (DIA)

This government document is issued by Department of Industrial Accidents (DIA) for use in Massachusetts

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File Details: PDF (151 KB)
Source
https://www.mass.gov/doc/form-112a-affidavit-in-support-of-request-for-waiver-of-filing-fee-under-ss-11c/download?_ga=2.148838583.1854129817.1751542062-2000327536.1747311789&_gl=1*1ipi86w*_ga*MjAwMDMyNzUzNi4xNzQ3MzExNzg5*_ga_MCLPEGW7WM*czE3NTE1NDIwNjIkbzY4JGcxJHQxNzUxNTQzODI1JGo2MCRsMCRoMA..

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