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Get CA DE 1870 2009

Cy ruled on the status of services performed by the worker or another person performing the same or similar services? Yes No Unknown If “Yes,” please attach a copy. 4. Total number of workers in this class __________ (Attach names, addresses, telephone numbers, and social security numbers. If more than 10 workers, attach the information for only 10). 5. This information is about services performed by the worker from ________________ to _________________. (Date) (Date) 6. State worker’s occ.

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