|Title||Assault - Related Incident Questionnaire|
|Purpose||To provide ESDC – Labour Program with information pertaining to the third party related to the claim under the Government Employees Compensation Act. (GECA)|
Returning the Form
|Employment and Social Development Canada|
ASSAULT-RELATED INCIDENT QUESTIONNAIRE - Electronic format revised by: leo morin, Oct. 17, 1996
PDF: ESDC-LAB1079, 132 KB, printed on 2 pages (8.5x14)
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