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CCU67 Department of Education TEACHER S ILLNESS CERTIFICATE This form should be used to certify illness for 1 to 7 calendar days. The completed form should be sent without delay to Department of Education Teachers Pay Pensions Team Pay Section Waterside House 75 Duke Street Gobnascale LONDONDERRY BT47 6FP Name Mr/Mrs/Miss/Ms Reference Number TR School/Institution School Reference Number I wish the period of absence detailed below to be treated as self certified sick leave. From first day of illness To last day of illness Nature of illness I understand that I must submit a doctor s statement from the 8th calendar day of a continuous period of sick leave. The completed form should be sent without delay to Department of Education Teachers Pay Pensions Team Pay Section Waterside House 75 Duke Street Gobnascale LONDONDERRY BT47 6FP Name Mr/Mrs/Miss/Ms Reference Number TR School/Institution School Reference Number I wish the period of absence detailed below to be treated as self certified sick leave. From first day of illness To last day of illness Nature of illness I understand that I must submit a doctor s statement from the 8th calendar day of a continuous period of sick leave.

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Keywords relevant to UK CCU67

  • Waterside
  • certify
  • pensions
  • tr
  • continuous
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