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Get Application For Certificate Of Coverage Under A Social Security Agreement

Tionship with the worker Protected B when completed I hereby certify that, to the best of my knowledge, the information contained in this request is accurate and complete. Print name and title of authorized officer or self-employed worker Authorized signing officer or self-employed worker Telephone number Date Certificate of coverage concerning the applicable legislation Canada Revenue Agency The worker named above is subject to the coverage provisions of the Canada Pension Plan and exemp.

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