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Get CA STD. 634 1998-2024

TO WORK SIGNATURE OF SUPERVISOR IF STILL DISABLED, GIVE ESTIMATED DATE OF RETURN TO WORK THE ILLNESS OR INJURY CAUSING THE DISABILITY WAS DATE SIGNATURE OF ATTENDING PHYSICIAN 12. PERIOD ON DISABILITY COMPENSATION FROM 13. DISABILITY COMPENSATION SUPPLEMENT TO SICK LEAVE HOURS VACATION CTO HOLIDAY CREDIT DATE 14. OFFICIAL DEPARTMENTAL ACTION APPROVED DISAPPROVED REVIEWED BY STATE OF CALIFORNIA ABSENCE AND ADDITIONAL TIME WORKED REPORT INSTRUCTIONS STD. 634 (REV.5-98) (REVERS.

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