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SUBMIT A SEPARATE DWC FORM-153 FOR EACH DWC OR IAB TEXAS DEPARTMENT OF INSURANCE DIVISION OF WORKERS COMPENSATION 7551 Metro Center Drive Suite 100 Austin TX 78744 REQUEST FOR COPIES OF CONFIDENTIAL CLAIMANT INFORMATION Please carefully read the information on both sides of this form and the accompanying Instructions. The original signed and notarized form should be mailed or personally delivered to the address indicated at top of DWC FORM-153. I.

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