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Person to whom it relates has or would have attained the age of 75 years, but in any event for at least 50 years from the date of the last entry. Part A - To be completed by employer (i) Details of employer Name Address (including postcode) (give address at which employee to which this record relates is employed) (ii) Details of employee Surname Forename(s) Permanent address (including postcode) Date of birth Sex Male Female National Insurance No Date of commencement as a classified per.

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