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Get AR ARK-AT-213 2012-2023

T S NAME: 2. SOCIAL SECURITY NUMBER: 3. ADDRESS (STREET OR BOX NUMBER): (CITY): 4. TELEPHONE NUMBER: ( ) (STATE): BENEFIT YEAR: (ZIP CODE): 5. ISSUE(S) APPEALED: Section(s) 6. I/We appeal from the determination of the Department of Workforce Services for the following reason(s): (Please attach a copy of the determination).

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