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Get Missouri Form 126

On by an employer or insurer. EMPLOYER: You must sign and date the statement below or this form will be returned to you. I hereby certify the information being sought by this request is being made on an applicant for employment only after a conditional job offer has been made, or on a current employee for a purpose which is job-related and consistent with business necessity. I further certify the information obtained in this request will not be used to discriminate in any manner against the indi.

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