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Number INS5246
Title CONSENT TO RELEASE INFORMATION
Purpose Complete this form to give permission to Employment and Social Development Canada (ESDC) to communicate with the workers’ compensation agency in your province or territory to ensure you receive the right amount of money from each source.
GroupEmployment Insurance

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CONSENT TO RELEASE INFORMATION
PDF: SC-INS5246, 115 KB, printed on 2 pages ( 8.5x11)

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