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Use SIDN number for all correspondence and inquiries until assigned a self-insured risk number. File all requests for data and financial statements, or we will return your application as incomplete. You must file this form with: ATTN: Self-Insured Department, Bureau of Workers Compensation, 30 W. Spring St., 27th Floor, Columbus, Ohio 43215-2256. Company Information Present state-fund risk number Federal ID number Name of applicant (shown exactly as it is in the Articles of Incorpo.

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