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Number EMP5453
Title WEPP - Appointment of Representative
Purpose This form is used to allow applicants to appoint a representative to apply for them is cases where they are medically incapacitated or are the beneficiary of a deceased applicant’s estate.
GroupWage Earner Protection Program
Important Information
Returning the Form

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Service Canada (SC)

PDF: SC-EMP5453, 233 KB, printed on 3 pages (8.5x11)

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