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Board Rule 61b41 Form Wcchange Of Address Change Of Address

This form is to be used only to change certain addresses of record.  For employees, this form only changes the employee’s address in a specifically identified claim.  For employers and attorneys, this form only needs to be filed once as this form will change information permanently in every claim.  Do not file this form if a party’s address is correct, but improperly listed in a claim.

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Seth Bader
(678) 562-5595