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Get COMPENSATION AGENCY SERVICE COMPANY APPLICATION - Michigan

Box 30016 Lansing, MI 48909 LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. Authority: Workers Disability Compensation Act of 1969, as amended Completion: Mandatory Penalty: Revocation of Service Company Status Name of Applicant hereby applies for approval to operate as a servicing company for qualified self-insurers under the Michigan Workers Disability Compensatio.

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