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Job Description Form
Offer Letter
Form Page 1 of 4
1.
Light Duty/Transitional Job
*
Employer Name:
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Phone #:
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Title:
Company
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Worker Name:
Claim #:
*
Date:
2.
Essential task description:
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Location
Choose one
Office
Yard/Warehouse
Job Site
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Hours per day:
0
1
2
3
4
5
6
7
8
9
10
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Days a week/shift:
0
1
2
3
4
5
