Apple Reference & Presentation Library 8 (Internal Edition)

home *** CD-ROM | disk | FTP | other *** search
/ Apple Reference & Presen…rary 8 (Internal Edition) / Apple R&P Lib Internal v8.0.iso / 1-Reference / Electronic Forms / Workers Compensation / Fremont Work Inj.⁄Ill.-Spvr. next >
MacBinary | 1990-06-24 | 34.3 KB | [STCK/KCFM]
open in:
MacOS 8.1 extracted |
Win98 extracted |
DOS extracted
view JSON data |
view as text

This file was processed as: MacBinary (archive/macBinary).

You can browse this item here: Fremont Work Inj.⁄Ill.-Spvr.
Confidence	Program	Detection	Match Type	Support
`10%`	dexvert	MacBinary `(archive/macBinary)`	fallback	Supported
`100%`	file	MacBinary II, inited, Sat Jun 23 19:03:05 1990, modified Sat Jun 23 19:03:05 1990, creator 'KCFM', type 'STCK', 33908 bytes "Fremont Work Inj./Ill.-Spvr." , at 0x84f4 976 bytes resource	default (weak)
`99%`	file	data	default
`66%`	TrID	SpeedScript document (C64)	default (weak)
`33%`	TrID	MacBinary 2	default (weak)
`100%`	siegfried	fmt/1762 MacBinary (II)	default
`100%`	lsar	MacBinary	default
id metadata
key	value
macFileType	`[STCK]`
macFileCreator	`[KCFM]`
hex view
+--------+-------------------------+-------------------------+--------+--------+
|00000000| 00 1c 46 72 65 6d 6f 6e | 74 20 57 6f 72 6b 20 49 |..Fremon|t Work I|
|00000010| 6e 6a 2e 2f 49 6c 6c 2e | 2d 53 70 76 72 2e 00 00 |nj./Ill.|-Spvr...|
|00000020| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000030| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000040| 00 53 54 43 4b 4b 43 46 | 4d 01 00 00 00 00 00 00 |.STCKKCF|M.......|
|00000050| 00 00 00 00 00 84 74 00 | 00 03 d0 a2 a9 a5 a9 a2 |......t.|........|
|00000060| a9 a5 a9 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000070| 00 00 00 00 00 00 00 00 | 00 00 81 81 86 b9 00 00 |........|........|
|00000080| 00 0c 00 02 00 00 00 30 | 00 00 68 04 00 00 01 de |.......0|..h.....|
|00000090| 00 00 3e 84 00 00 3e 86 | 00 00 83 54 00 00 00 00 |..>...>.|...T....|
|000000a0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000000b0| 09 90 0c 60 00 01 00 01 | 00 00 00 00 00 01 00 00 |...`....|........|
|000000c0| 00 00 00 00 00 03 00 01 | 00 01 00 03 00 00 00 48 |........|.......H|
|000000d0| 00 48 00 00 00 00 03 08 | 02 40 ff f8 ff ee 03 10 |.H......|.@......|
|000000e0| 02 52 03 47 05 28 03 fc | 00 02 00 00 00 48 00 48 |.R.G.(..|.....H.H|
|000000f0| 00 00 00 00 03 08 02 40 | 00 01 00 00 00 64 00 00 |.......@|.....d..|
|00000100| 00 01 00 01 01 01 00 00 | 00 01 27 0f 00 01 00 01 |........|..'.....|
|00000110| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 00 19 |........|........|
|00000120| 01 90 00 00 00 00 00 70 | 00 00 00 00 00 00 00 00 |.......p|........|
|00000130| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000140| 00 00 00 00 01 48 00 01 | 00 06 00 06 40 38 00 00 |.....H..|....@8..|
|00000150| 00 00 00 00 40 38 00 00 | 00 00 00 00 00 2f 00 02 |....@8..|...../..|
|00000160| 00 01 00 00 00 00 00 04 | 01 f4 01 26 00 34 00 30 |........|...&.4.0|
|00000170| 00 01 00 14 00 01 00 09 | 00 00 00 0d 00 00 00 15 |........|........|
|00000180| 00 03 00 0c 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000190| 00 00 00 00 00 00 00 00 | 00 03 00 03 00 00 ff ff |........|........|
|000001a0| ff ff ff ff ff ff 00 02 | 00 02 00 25 ae 32 00 25 |........|...%.2.%|
|000001b0| ae 38 00 20 4e d2 00 20 | 4e d2 00 00 00 00 00 00 |.8. N.. |N.......|
|000001c0| 00 01 00 01 00 01 00 01 | 00 01 00 01 00 00 00 00 |........|........|
|000001d0| 00 00 00 01 00 00 00 00 | 00 00 00 00 00 00 00 48 |........|.......H|
|000001e0| 00 07 00 00 00 01 09 90 | 0c 60 00 20 00 48 0c 3d |........|.`. .H.=|
|000001f0| 09 45 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |.E......|........|
|00000200| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000210| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000220| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000230| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000240| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000250| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 09 |........|........|
|00000260| 00 00 01 68 0b 90 00 10 | 0c 48 09 44 00 01 00 00 |...h....|.H.D....|
|00000270| 00 14 00 01 00 12 00 00 | 00 03 00 03 00 00 00 00 |........|........|
|00000280| 00 04 00 7c 00 00 00 01 | 00 03 00 00 00 00 00 00 |...|....|........|
|00000290| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000002a0| 00 00 00 03 00 03 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000002b0| 01 20 01 20 00 3c 00 28 | 00 00 00 39 40 80 00 00 |. . .<.(|...9@...|
|000002c0| 00 00 00 01 00 00 00 01 | 00 00 00 00 00 ae 00 02 |........|........|
|000002d0| 0b 90 00 10 0b cc 09 45 | 01 01 80 81 00 14 00 0c |.......E|........|
|000002e0| 00 00 00 00 00 03 00 02 | 00 01 00 75 50 6c 65 61 |........|...uPlea|
|000002f0| 73 65 20 62 65 20 73 75 | 72 65 20 74 6f 20 70 72 |se be su|re to pr|
|00000300| 69 6e 74 20 77 69 74 68 | 20 22 50 72 69 6e 74 20 |int with| "Print |
|00000310| 77 69 74 68 20 50 61 72 | 74 20 4c 61 62 65 6c 73 |with Par|t Labels|
|00000320| 22 20 6f 70 74 69 6f 6e | 20 73 65 6c 65 63 74 65 |" option| selecte|
|00000330| 64 2e 20 20 46 6f 6c 64 | 20 61 6e 64 20 4d 61 69 |d.  Fold| and Mai|
|00000340| 6c 20 74 6f 20 74 68 65 | 20 44 65 70 61 72 74 6d |l to the| Departm|
|00000350| 65 6e 74 20 6c 69 73 74 | 65 64 20 62 65 6c 6f 77 |ent list|ed below|
|00000360| 2e 5e 00 00 00 16 00 01 | 00 00 00 00 00 0c 00 09 |.^......|........|
|00000370| 00 14 00 00 00 0c 00 00 | 00 00 00 00 00 4e 53 69 |........|.....NSi|
|00000380| 74 65 20 4e 75 72 73 65 | 2f 46 72 65 6d 6f 6e 74 |te Nurse|/Fremont|
|00000390| 20 45 48 26 53 20 44 65 | 70 74 2e 2c 48 75 6d 61 | EH&S De|pt.,Huma|
|000003a0| 6e 20 52 65 73 6f 75 72 | 63 65 73 20 4c 69 61 69 |n Resour|ces Liai|
|000003b0| 73 6f 6e 2c 20 53 75 70 | 65 72 76 69 73 6f 72 2f |son, Sup|ervisor/|
|000003c0| 4d 61 6e 61 67 65 72 20 | 43 6f 70 79 00 03 00 00 |Manager |Copy....|
|000003d0| 00 34 00 24 00 4c 0b d0 | 09 44 00 01 00 01 00 03 |.4.$.L..|.D......|
|000003e0| 00 01 ff ff ff ff ff ff | ff ff 00 00 00 00 00 00 |........|........|
|000003f0| 00 00 00 00 00 01 00 28 | 00 28 00 28 00 28 00 00 |.......(|.(.(.(..|
|00000400| 00 00 00 00 00 00 00 0d | 00 00 00 88 09 f0 00 b4 |........|........|
|00000410| 0a e0 09 24 00 00 00 02 | 00 02 00 02 00 02 00 02 |...$....|........|
|00000420| 00 03 00 00 00 34 0a 08 | 00 b4 0a e0 09 10 00 01 |.....4..|........|
|00000430| 00 00 00 03 00 00 ff ff | ff ff ff ff ff ff 00 00 |........|........|
|00000440| aa 55 aa 55 aa 55 aa 55 | 00 01 00 00 00 00 00 00 |.U.U.U.U|........|
|00000450| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 00 34 |........|.......4|
|00000460| 09 f0 00 c8 0a cc 09 24 | 00 01 00 00 00 03 00 00 |.......$|........|
|00000470| ff ff ff ff ff ff ff ff | 00 00 00 00 00 00 00 00 |........|........|
|00000480| 00 00 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000490| 00 00 00 00 00 07 00 00 | 00 e2 00 a0 01 3c 01 04 |........|.....<..|
|000004a0| 09 24 00 01 00 00 ff ff | ff ff ff ff ff ff 00 01 |.$......|........|
|000004b0| 00 00 00 00 00 00 00 02 | 00 a0 01 3c 01 04 09 24 |........|...<...$|
|000004c0| 00 00 00 00 00 14 00 0c | 00 00 00 00 00 01 00 01 |........|........|
|000004d0| 00 02 00 8e 43 6f 6d 70 | 6c 65 74 65 20 77 69 74 |....Comp|lete wit|
|000004e0| 68 69 6e 20 32 34 20 68 | 6f 75 72 73 20 6f 66 20 |hin 24 h|ours of |
|000004f0| 61 20 77 6f 72 6b 20 69 | 6e 6a 75 72 79 20 2f 20 |a work i|njury / |
|00000500| 69 6c 6c 6e 65 73 73 2e | 20 20 49 6e 20 74 68 65 |illness.|  In the|
|00000510| 20 65 76 65 6e 74 20 6f | 66 20 73 65 72 69 6f 75 | event o|f seriou|
|00000520| 73 20 69 6e 6a 75 72 79 | 20 6f 72 20 64 65 61 74 |s injury| or deat|
|00000530| 68 20 69 6d 6d 65 64 69 | 61 74 65 6c 79 20 6e 6f |h immedi|ately no|
|00000540| 74 69 66 79 20 41 70 70 | 6c 65 20 53 65 63 75 72 |tify App|le Secur|
|00000550| 69 74 79 20 61 6e 64 2f | 6f 72 20 53 61 66 65 74 |ity and/|or Safet|
|00000560| 79 2e 00 00 00 16 00 01 | 00 00 00 00 00 0c 00 09 |y.......|........|
|00000570| 00 14 00 00 00 0c 00 00 | 00 00 00 00 00 0d 00 00 |........|........|
|00000580| 00 88 01 10 00 b0 03 24 | 09 20 00 00 00 00 00 00 |.......$|. ......|
|00000590| 00 01 00 01 00 02 00 03 | 00 00 00 34 01 2c 00 b0 |........|...4.,..|
|000005a0| 03 24 09 0b 00 01 00 00 | 00 03 00 00 ff ff ff ff |.$......|........|
|000005b0| ff ff ff ff 00 00 aa 55 | aa 55 aa 55 aa 55 00 01 |.......U|.U.U.U..|
|000005c0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000005d0| 00 03 00 00 00 34 01 10 | 00 c4 03 10 09 20 00 01 |.....4..|..... ..|
|000005e0| 00 00 00 03 00 00 ff ff | ff ff ff ff ff ff 00 00 |........|........|
|000005f0| 00 00 00 00 00 00 00 00 | 00 01 00 00 00 00 00 00 |........|........|
|00000600| 00 00 00 00 00 00 00 00 | 00 00 00 0d 00 00 00 88 |........|........|
|00000610| 03 40 00 b0 07 0c 09 20 | 00 00 00 00 00 00 00 01 |.@..... |........|
|00000620| 00 01 00 02 00 03 00 00 | 00 34 03 60 00 b0 07 0c |........|.4.`....|
|00000630| 09 0b 00 01 00 00 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00000640| ff ff 00 00 aa 55 aa 55 | aa 55 aa 55 00 01 00 00 |.....U.U|.U.U....|
|00000650| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|00000660| 00 00 00 34 03 40 00 c4 | 06 f8 09 20 00 01 00 00 |...4.@..|... ....|
|00000670| 00 03 00 00 ff ff ff ff | ff ff ff ff 00 00 00 00 |........|........|
|00000680| 00 00 00 00 00 00 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00000690| 00 00 00 00 00 00 00 00 | 00 06 00 00 02 b0 03 da |........|........|
|000006a0| 00 70 05 fa 00 a8 00 01 | 00 00 03 da 00 70 05 fa |.p......|.....p..|
|000006b0| 00 a8 00 30 00 28 02 a0 | 00 60 00 00 00 00 02 7e |...0.(..|.`.....~|
|000006c0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000006d0| 02 7e ff ff ff ff 00 9b | 00 0d 11 01 a0 00 82 a1 |.~......|........|
|000006e0| 00 96 00 0c 01 00 01 0e | 02 00 01 0e 00 00 00 00 |........|........|
|000006f0| a1 00 9a 00 08 ff fc 00 | 00 00 4c 00 00 03 00 14 |........|..L.....|
|00000700| 04 01 0d 00 0a 28 00 50 | ff ba 14 49 4e 43 49 44 |.....(.P|...INCID|
|00000710| 45 4e 54 20 49 4e 46 4f | 52 4d 41 54 49 4f 4e 01 |ENT INFO|RMATION.|
|00000720| 00 0a 00 00 00 00 00 9a | 00 0c 90 00 04 00 00 00 |........|........|
|00000730| 00 00 80 00 20 00 00 00 | 00 00 80 00 20 00 1a 00 |.... ...|.... ...|
|00000740| 00 00 9a 00 20 00 01 00 | 00 00 00 1f c0 00 00 1f |.... ...|........|
|00000750| c0 00 00 13 00 00 00 06 | 40 00 00 1f c0 00 00 1f |........|@.......|
|00000760| c0 00 00 10 40 00 00 00 | 00 00 00 07 00 00 00 0f |....@...|........|
|00000770| 80 00 00 18 c0 00 00 10 | 40 00 00 18 c0 00 00 0f |........|@.......|
|00000780| 80 00 00 07 00 00 00 10 | 40 00 00 1f c0 00 00 1f |........|@.......|
|00000790| c0 00 00 10 40 00 00 00 | 00 00 00 18 00 00 00 18 |....@...|........|
|000007a0| 40 00 00 1f c0 00 00 1f | c0 00 00 18 40 00 00 18 |@.......|....@...|
|000007b0| 40 00 00 01 c0 00 00 07 | c0 00 00 1f 40 00 00 1f |@.......|....@...|
|000007c0| 40 00 00 07 c0 00 00 01 | c0 00 00 10 40 00 00 1f |@.......|....@...|
|000007d0| c0 00 00 1f c0 00 00 1e | 40 00 00 07 80 00 00 07 |........|@.......|
|000007e0| 80 00 00 1e 40 00 00 1f | c0 00 00 1f c0 00 00 10 |....@...|........|
|000007f0| 40 00 00 00 00 00 00 0c | 40 00 00 1e c0 00 00 13 |@.......|@.......|
|00000800| c0 00 00 13 40 00 00 1f | c0 00 00 1f c0 00 00 10 |....@...|........|
|00000810| 40 00 00 07 00 00 00 0f | 80 00 00 18 c0 00 00 10 |@.......|........|
|00000820| 40 00 00 18 c0 00 00 0f | 80 00 00 07 00 00 00 18 |@.......|........|
|00000830| 00 00 00 1a 00 00 00 12 | 40 00 00 1f c0 00 00 1f |........|@.......|
|00000840| c0 00 00 10 40 00 00 10 | 00 00 00 1f c0 00 00 1f |....@...|........|
|00000850| c0 00 00 13 00 00 00 06 | 40 00 00 1f c0 00 00 1f |........|@.......|
|00000860| c0 00 00 10 40 00 00 10 | 40 00 00 1f c0 00 00 1f |....@...|@.......|
|00000870| c0 00 00 10 40 00 00 00 | 00 00 00 00 00 00 00 00 |....@...|........|
|00000880| 00 00 00 18 00 00 00 18 | 40 00 00 1f c0 00 00 1f |........|@.......|
|00000890| c0 00 00 18 40 00 00 18 | 00 00 00 1f c0 00 00 1f |....@...|........|
|000008a0| c0 00 00 13 00 00 00 06 | 40 00 00 1f c0 00 00 1f |........|@.......|
|000008b0| c0 00 00 10 40 00 00 00 | 00 00 00 18 c0 00 00 1a |....@...|........|
|000008c0| c0 00 00 12 40 00 00 1f | c0 00 00 1f c0 00 00 10 |....@...|........|
|000008d0| 40 00 00 07 00 00 00 0f | 80 00 00 18 c0 00 00 10 |@.......|........|
|000008e0| 40 00 00 1f c0 00 00 1f | c0 00 00 10 40 00 00 10 |@.......|....@...|
|000008f0| 40 00 00 1f c0 00 00 1f | c0 00 00 10 40 00 00 18 |@.......|....@...|
|00000900| 80 00 00 18 c0 00 00 10 | 40 00 00 10 40 00 00 18 |........|@...@...|
|00000910| c0 00 00 0f 80 00 00 17 | 00 00 00 1f c0 00 00 1f |........|........|
|00000920| c0 00 00 13 00 00 00 06 | 40 00 00 1f c0 00 00 1f |........|@.......|
|00000930| c0 00 00 10 40 00 00 10 | 40 00 00 1f c0 00 00 1f |....@...|@.......|
|00000940| c0 00 00 10 40 00 00 a0 | 00 97 a0 00 83 ff 00 07 |....@...|........|
|00000950| 00 00 00 86 00 38 00 4c | 00 a4 09 44 00 01 00 00 |.....8.L|...D....|
|00000960| ff ff ff ff ff ff ff ff | 00 01 00 00 00 00 00 00 |........|........|
|00000970| 00 02 00 38 00 4c 00 a4 | 09 44 00 00 00 00 00 14 |...8.L..|.D......|
|00000980| 00 0e 00 01 00 00 00 03 | 00 03 00 01 00 31 46 52 |........|.....1FR|
|00000990| 45 4d 4f 4e 54 20 57 4f | 52 4b 20 49 4e 4a 55 52 |EMONT WO|RK INJUR|
|000009a0| 59 20 2f 20 49 4c 4c 4e | 45 53 53 20 52 45 50 4f |Y / ILLN|ESS REPO|
|000009b0| 52 54 20 2d 20 53 55 50 | 45 52 56 49 53 4f 52 01 |RT - SUP|ERVISOR.|
|000009c0| 00 00 00 16 00 01 00 00 | 00 00 00 0f 00 0c 00 14 |........|........|
|000009d0| 01 00 00 0e 00 00 00 00 | 00 00 00 0d 00 00 00 cc |........|........|
|000009e0| 00 5c 00 94 00 d0 00 fc | 00 00 00 00 00 00 00 00 |.\......|........|
|000009f0| 00 00 00 02 00 07 00 00 | 00 56 00 5c 00 94 00 d0 |........|.V.\....|
|00000a00| 00 fa 00 01 00 00 ff ff | ff ff ff ff ff ff 00 01 |........|........|
|00000a10| 00 00 00 00 00 00 00 02 | 00 5c 00 94 00 d0 00 fa |........|.\......|
|00000a20| 00 00 00 00 00 14 00 18 | 00 00 00 00 00 03 00 03 |........|........|
|00000a30| 00 01 00 01 f0 00 00 00 | 00 16 00 01 00 00 00 00 |........|........|
|00000a40| 00 18 00 12 00 14 00 00 | 00 18 00 00 00 00 00 00 |........|........|
|00000a50| 00 07 00 00 00 56 00 a1 | 00 df 00 ba 00 fc 00 01 |.....V..|........|
|00000a60| 00 00 ff ff ff ff ff ff | ff ff 00 01 00 00 00 00 |........|........|
|00000a70| 00 00 00 02 00 a1 00 df | 00 ba 00 fc 00 00 00 00 |........|........|
|00000a80| 00 14 00 04 00 00 00 00 | 00 03 00 03 00 01 00 01 |........|........|
|00000a90| a8 00 00 00 00 16 00 01 | 00 00 00 00 00 05 00 04 |........|........|
|00000aa0| 00 14 00 00 00 04 00 00 | 00 00 00 00 00 07 00 00 |........|........|
|00000ab0| 00 68 0b f4 00 4c 0c 3c | 02 38 00 01 00 01 ff ff |.h...L.<|.8......|
|00000ac0| ff ff ff ff ff ff 00 01 | 00 00 00 00 00 00 00 02 |........|........|
|00000ad0| 0b f4 00 4c 0c 3c 02 38 | 00 00 00 00 00 14 00 0e |...L.<.8|........|
|00000ae0| 00 20 00 00 00 01 00 03 | 00 01 00 14 41 70 70 6c |. ......|....Appl|
|00000af0| 65 20 43 6f 6d 70 75 74 | 65 72 2c 20 49 6e 63 2e |e Comput|er, Inc.|
|00000b00| 00 00 00 16 00 01 00 00 | 00 00 00 0f 00 0c 00 14 |........|........|
|00000b10| 20 00 00 0e 00 00 00 00 | 00 00 00 07 00 00 00 62 | .......|.......b|
|00000b20| 0b fc 08 1c 0c 3c 09 44 | 00 01 00 00 ff ff ff ff |.....<.D|........|
|00000b30| ff ff ff ff 00 01 00 00 | 00 00 00 00 00 02 0b fc |........|........|
|00000b40| 08 1c 0c 3c 09 44 00 00 | 00 00 00 14 00 0a 00 00 |...<.D..|........|
|00000b50| 00 00 00 02 00 03 00 01 | 00 0e 52 53 4b 33 30 30 |........|..RSK300|
|00000b60| 20 28 30 31 2f 39 31 29 | 00 00 00 16 00 01 00 00 | (01/91)|........|
|00000b70| 00 00 00 0c 00 09 00 14 | 00 00 00 0a 00 00 00 00 |........|........|
|00000b80| 00 00 00 07 00 00 00 8a | 00 d8 06 70 01 07 09 20 |........|...p... |
|00000b90| 00 01 00 00 80 00 08 00 | 80 00 08 00 00 00 00 00 |........|........|
|00000ba0| 00 00 00 00 00 02 00 d8 | 06 70 01 07 09 20 00 00 |........|.p... ..|
|00000bb0| 00 00 00 14 00 0c ff 00 | 00 00 00 01 00 01 00 01 |........|........|
|00000bc0| 00 21 41 70 70 6c 65 20 | 43 6f 6e 66 69 64 65 6e |.!Apple |Confiden|
|00000bd0| 74 69 61 6c 3a 20 20 4e | 65 65 64 20 74 6f 20 4b |tial:  N|eed to K|
|00000be0| 6e 6f 77 6e 00 00 00 2a | 00 02 00 00 00 00 00 0c |nown...*|........|
|00000bf0| 00 09 00 14 00 00 00 0c | 00 00 00 00 00 00 00 00 |........|........|
|00000c00| 00 06 00 0c 00 09 00 14 | 02 00 00 0c 00 00 00 00 |........|........|
|00000c10| 00 00 00 06 00 00 02 d0 | 00 f0 00 70 03 2c 00 a8 |........|...p.,..|
|00000c20| 00 01 00 00 00 f0 00 70 | 03 2c 00 a8 00 30 00 28 |.......p|.,...0.(|
|00000c30| 02 6c 00 60 00 00 00 00 | 02 9e 00 00 00 00 00 00 |.l.`....|........|
|00000c40| 00 00 00 00 00 00 00 00 | 00 00 02 9e ff ff ff ff |........|........|
|00000c50| 00 8e 00 0d 11 01 a0 00 | 82 a1 00 96 00 0c 01 00 |........|........|
|00000c60| 01 0e 02 00 01 0e 00 00 | 00 00 a1 00 9a 00 08 ff |........|........|
|00000c70| fc 00 00 00 45 00 00 03 | 00 14 04 01 0d 00 0a 28 |....E...|.......(|
|00000c80| 00 4a ff c1 14 45 4d 50 | 4c 4f 59 45 45 20 49 4e |.J...EMP|LOYEE IN|
|00000c90| 46 4f 52 4d 41 54 49 4f | 4e 01 00 0a 00 00 00 00 |FORMATIO|N.......|
|00000ca0| 00 8d 00 0c 90 00 04 00 | 00 00 00 00 88 00 20 00 |........|...... .|
|00000cb0| 00 00 00 00 88 00 20 00 | 05 00 00 00 8d 00 20 00 |...... .|...... .|
|00000cc0| 01 00 00 00 00 10 00 00 | 00 1f c0 00 00 1f c0 00 |........|........|
|00000cd0| 00 13 00 00 00 06 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00000ce0| 00 10 40 00 00 00 00 00 | 00 07 00 00 00 0f 80 00 |..@.....|........|
|00000cf0| 00 18 c0 00 00 10 40 00 | 00 18 c0 00 00 0f 80 00 |......@.|........|
|00000d00| 00 07 00 00 00 10 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00000d10| 00 10 40 00 00 18 00 00 | 00 18 40 00 00 1f c0 00 |..@.....|..@.....|
|00000d20| 00 1f c0 00 00 18 40 00 | 00 18 00 00 00 00 40 00 |......@.|......@.|
|00000d30| 00 01 c0 00 00 07 c0 00 | 00 1f 40 00 00 1f 40 00 |........|..@...@.|
|00000d40| 00 07 c0 00 00 01 c0 00 | 00 10 40 00 00 1f c0 00 |........|..@.....|
|00000d50| 00 1f c0 00 00 1e 40 00 | 00 07 80 00 00 07 80 00 |......@.|........|
|00000d60| 00 1e 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00000d70| 00 0c 40 00 00 1e c0 00 | 00 13 c0 00 00 13 40 00 |..@.....|......@.|
|00000d80| 00 1f c0 00 00 1f c0 00 | 00 10 40 00 00 00 00 00 |........|..@.....|
|00000d90| 00 07 00 00 00 0f 80 00 | 00 18 c0 00 00 10 40 00 |........|......@.|
|00000da0| 00 18 c0 00 00 0f 80 00 | 00 07 00 00 00 18 00 00 |........|........|
|00000db0| 00 1a 00 00 00 12 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00000dc0| 00 10 40 00 00 1f c0 00 | 00 1f c0 00 00 13 00 00 |..@.....|........|
|00000dd0| 00 06 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00000de0| 00 10 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00000df0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 18 c0 00 |........|........|
|00000e00| 00 1a c0 00 00 12 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00000e10| 00 10 40 00 00 00 00 00 | 00 18 c0 00 00 1a c0 00 |..@.....|........|
|00000e20| 00 12 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00000e30| 00 18 00 00 00 1c 40 00 | 00 17 c0 00 00 17 c0 00 |......@.|........|
|00000e40| 00 1c 40 00 00 18 00 00 | 00 10 00 00 00 00 00 00 |..@.....|........|
|00000e50| 00 07 00 00 00 0f 80 00 | 00 18 c0 00 00 10 40 00 |........|......@.|
|00000e60| 00 18 c0 00 00 0f 80 00 | 00 07 00 00 00 00 00 00 |........|........|
|00000e70| 00 00 c0 00 00 00 c0 00 | 00 10 40 00 00 1f c0 00 |........|..@.....|
|00000e80| 00 1f c0 00 00 10 40 00 | 00 0c 00 00 00 1e 00 00 |......@.|........|
|00000e90| 00 12 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00000ea0| 00 1f c0 00 00 1f c0 00 | 00 1e 40 00 00 07 80 00 |........|..@.....|
|00000eb0| 00 07 80 00 00 1e 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00000ec0| 00 10 40 00 00 00 00 00 | 00 18 c0 00 00 1a c0 00 |..@.....|........|
|00000ed0| 00 12 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00000ee0| 00 a0 00 97 a0 00 83 ff | 00 01 00 00 00 ac 01 1c |........|........|
|00000ef0| 00 e4 01 64 06 34 00 01 | 00 00 00 00 00 15 00 00 |...d.4..|........|
|00000f00| 00 0c 00 00 00 03 00 02 | 00 2a 00 01 00 02 00 00 |........|.*......|
|00000f10| 00 00 00 04 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000f20| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|00000f30| ff ff ff ff 01 3c 00 c8 | 00 18 00 18 00 00 01 12 |.....<..|........|
|00000f40| 00 01 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000f50| 00 00 00 00 00 02 01 1c | 00 e4 01 65 02 20 01 01 |........|...e. ..|
|00000f60| 81 80 00 14 00 09 00 00 | 00 00 00 01 00 02 00 01 |........|........|
|00000f70| 00 0d 45 4d 50 4c 4f 59 | 45 45 20 4e 41 4d 45 b6 |..EMPLOY|EE NAME.|
|00000f80| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|00000f90| 00 00 00 09 00 00 00 00 | 00 00 00 01 00 00 00 a8 |........|........|
|00000fa0| 01 1c 06 3c 01 64 08 f2 | 00 01 00 00 00 00 00 15 |...<.d..|........|
|00000fb0| 00 00 00 0c 00 00 00 03 | 00 02 00 01 00 01 00 02 |........|........|
|00000fc0| 00 00 00 00 00 04 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00000fd0| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|00000fe0| ff ff ff ff ff ff 00 fc | 01 24 00 34 00 30 00 00 |........|.$.4.0..|
|00000ff0| 01 13 00 02 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001000| 00 00 00 00 00 00 00 02 | 01 1c 06 3c 01 65 07 38 |........|...<.e.8|
|00001010| 01 01 81 80 00 14 00 09 | 00 00 00 00 00 01 00 02 |........|........|
|00001020| 00 01 00 0a 57 4f 52 4b | 20 50 48 4f 4e 45 00 00 |....WORK| PHONE..|
|00001030| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00001040| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 a8 01 64 |........|.......d|
|00001050| 00 e4 01 ac 05 1c 00 01 | 00 00 00 00 00 15 00 00 |........|........|
|00001060| 00 0c 00 00 00 03 00 02 | 00 00 00 01 00 02 00 00 |........|........|
|00001070| 00 00 00 04 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001080| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|00001090| ff ff ff ff 00 b8 01 24 | 00 34 00 30 00 00 01 14 |.......$|.4.0....|
|000010a0| 00 03 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000010b0| 00 00 00 00 00 02 01 64 | 00 e4 01 ad 01 9c 01 01 |.......d|........|
|000010c0| 81 80 00 14 00 09 00 00 | 00 00 00 01 00 02 00 01 |........|........|
|000010d0| 00 09 4a 4f 42 20 54 49 | 54 4c 45 db 00 00 00 16 |..JOB TI|TLE.....|
|000010e0| 00 01 00 00 00 00 00 0b | 00 08 00 14 00 00 00 09 |........|........|
|000010f0| 00 00 00 00 00 00 00 01 | 00 00 00 a2 01 6c 05 d8 |........|.....l..|
|00001100| 01 b4 06 80 00 01 00 00 | 00 00 00 15 00 00 00 0c |........|........|
|00001110| 00 00 00 03 00 03 00 01 | 00 01 00 04 00 00 00 00 |........|........|
|00001120| 00 04 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001130| 00 00 00 00 00 00 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00001140| ff ff 00 54 00 78 00 34 | 00 30 00 00 01 15 00 04 |...T.x.4|.0......|
|00001150| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001160| 00 00 00 02 01 6c 06 08 | 01 b5 06 81 01 00 81 81 |.....l..|........|
|00001170| 00 14 00 09 00 00 00 00 | 00 03 00 03 00 01 00 04 |........|........|
|00001180| 4d 41 4c 45 00 00 00 16 | 00 01 00 00 00 00 00 0b |MALE....|........|
|00001190| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 01 |........|........|
|000011a0| 00 00 00 a4 01 68 06 f8 | 01 b4 07 c4 00 01 00 00 |.....h..|........|
|000011b0| 00 00 00 15 00 00 00 0c | 00 00 00 03 00 03 00 01 |........|........|
|000011c0| 00 01 00 04 00 00 00 00 | 00 04 00 00 00 00 00 00 |........|........|
|000011d0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|000011e0| 00 00 ff ff ff ff ff ff | ff ff 00 54 00 9c 00 34 |........|...T...4|
|000011f0| 00 30 00 00 01 16 00 05 | 00 01 00 00 00 00 00 00 |.0......|........|
|00001200| 00 00 00 00 00 00 00 00 | 00 00 00 02 01 68 07 28 |........|.....h.(|
|00001210| 01 b5 07 c5 01 00 81 81 | 00 14 00 09 00 00 00 00 |........|........|
|00001220| 00 03 00 03 00 01 00 06 | 46 45 4d 41 4c 45 00 00 |........|FEMALE..|
|00001230| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00001240| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 a8 01 ac |........|........|
|00001250| 00 e4 01 f4 02 2c 00 01 | 00 00 00 00 00 15 00 00 |.....,..|........|
|00001260| 00 0c 00 00 00 03 00 02 | 00 00 00 01 00 02 00 00 |........|........|
|00001270| 00 00 00 04 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001280| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|00001290| ff ff ff ff 00 d0 00 b4 | 00 34 00 30 00 00 01 17 |........|.4.0....|
|000012a0| 00 06 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000012b0| 00 00 00 00 00 02 01 ac | 00 e4 01 f5 01 b4 01 01 |........|........|
|000012c0| 81 80 00 14 00 09 00 00 | 00 00 00 01 00 02 00 01 |........|........|
|000012d0| 00 0a 44 49 56 49 53 49 | 4f 4e 20 23 00 00 00 16 |..DIVISI|ON #....|
|000012e0| 00 01 00 00 00 00 00 0b | 00 08 00 14 00 00 00 09 |........|........|
|000012f0| 00 00 00 00 00 00 00 01 | 00 00 00 aa 01 ac 02 38 |........|.......8|
|00001300| 01 fc 03 cc 00 01 00 00 | 00 00 00 15 00 00 00 0c |........|........|
|00001310| 00 00 00 03 00 02 00 00 | 00 01 00 02 00 00 00 00 |........|........|
|00001320| 00 04 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001330| 00 00 00 00 00 00 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00001340| ff ff 01 1c 00 b4 00 34 | 00 30 00 00 01 18 00 07 |.......4|.0......|
|00001350| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001360| 00 00 00 02 01 ac 02 38 | 01 fd 03 54 01 01 81 80 |.......8|...T....|
|00001370| 00 14 00 09 00 00 00 00 | 00 01 00 02 00 01 00 0c |........|........|
|00001380| 44 45 50 41 52 54 4d 45 | 4e 54 20 23 00 00 00 16 |DEPARTME|NT #....|
|00001390| 00 01 00 00 00 00 00 0b | 00 08 00 14 00 00 00 09 |........|........|
|000013a0| 00 00 00 00 00 00 00 01 | 00 00 00 ac 01 b4 06 a0 |........|........|
|000013b0| 01 fc 08 b4 00 01 00 00 | 00 00 00 15 00 00 00 0c |........|........|
|000013c0| 00 00 00 03 00 02 00 00 | 00 01 00 02 00 00 00 00 |........|........|
|000013d0| 00 04 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000013e0| 00 00 00 00 00 00 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|000013f0| ff ff 01 2c 01 24 00 2c | 00 2c 00 00 01 19 00 09 |...,.$.,|.,......|
|00001400| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001410| 00 00 00 02 01 b4 06 a0 | 01 fd 07 cc 01 01 81 80 |........|........|
|00001420| 00 14 00 09 00 00 00 00 | 00 01 00 02 00 01 00 0d |........|........|
|00001430| 44 41 54 45 20 52 45 50 | 4f 52 54 45 44 3c 00 00 |DATE REP|ORTED<..|
|00001440| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00001450| 00 09 00 00 00 00 00 00 | 00 07 00 00 00 66 02 04 |........|.....f..|
|00001460| 00 e4 02 2f 02 80 00 01 | 00 00 ff ff ff ff ff ff |.../....|........|
|00001470| ff ff 00 01 00 00 00 00 | 00 00 00 02 02 04 00 e4 |........|........|
|00001480| 02 2f 02 80 00 00 00 00 | 00 14 00 09 00 00 00 00 |./......|........|
|00001490| 00 01 00 01 00 01 00 12 | 45 4d 50 4c 4f 59 4d 45 |........|EMPLOYME|
|000014a0| 4e 54 20 53 54 41 54 55 | 53 3a 00 00 00 16 00 01 |NT STATU|S:......|
|000014b0| 00 00 00 00 00 0b 00 08 | 00 14 00 00 00 09 00 00 |........|........|
|000014c0| 00 00 00 00 00 07 00 00 | 00 72 02 3c 01 48 02 64 |........|.r.<.H.d|
|000014d0| 03 c4 00 01 00 00 ff ff | ff ff ff ff ff ff 00 01 |........|........|
|000014e0| 00 00 00 00 00 00 00 02 | 02 3c 01 48 02 64 03 c4 |........|.<.H.d..|
|000014f0| 00 00 00 00 00 14 00 09 | 00 00 00 00 00 01 00 01 |........|........|
|00001500| 00 01 00 1e 52 45 47 55 | 4c 41 52 20 46 55 4c 4c |....REGU|LAR FULL|
|00001510| 20 54 49 4d 45 20 4f 52 | 20 50 41 52 54 20 54 49 | TIME OR| PART TI|
|00001520| 4d 45 00 00 00 16 00 01 | 00 00 00 00 00 0b 00 08 |ME......|........|
|00001530| 00 14 00 00 00 09 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|00001540| 00 a8 02 70 00 e4 02 b8 | 03 94 00 01 00 00 00 00 |...p....|........|
|00001550| 00 15 00 00 00 0c 00 00 | 00 03 00 02 00 00 00 01 |........|........|
|00001560| 00 02 00 00 00 00 00 04 | 00 01 00 00 00 00 00 00 |........|........|
|00001570| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 03 00 00 |........|........|
|00001580| ff ff ff ff ff ff ff ff | 00 f0 01 24 00 34 00 30 |........|...$.4.0|
|00001590| 00 00 01 1c 00 0b 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|000015a0| 00 00 00 00 00 00 00 00 | 00 02 02 70 00 e4 02 b9 |........|...p....|
|000015b0| 01 d4 01 01 81 80 00 14 | 00 09 00 00 00 00 00 01 |........|........|
|000015c0| 00 02 00 01 00 0a 45 4d | 50 4c 4f 59 45 45 20 23 |......EM|PLOYEE #|
|000015d0| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|000015e0| 00 00 00 09 00 00 00 00 | 00 00 00 01 00 00 00 aa |........|........|
|000015f0| 02 70 03 d8 02 b8 06 74 | 00 01 00 00 00 00 00 15 |.p.....t|........|
|00001600| 00 00 00 0c 00 00 00 03 | 00 02 00 00 00 01 00 02 |........|........|
|00001610| 00 00 00 00 00 04 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00001620| 00 00 00 00 00 00 00 00 | 00 03 00 03 00 00 ff ff |........|........|
|00001630| ff ff ff ff ff ff 01 20 | 01 24 00 34 00 30 00 00 |....... |.$.4.0..|
|00001640| 01 1d 00 0d 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001650| 00 00 00 00 00 00 00 02 | 02 70 03 d8 02 b9 04 f8 |........|.p......|
|00001660| 01 01 81 80 00 14 00 09 | 00 00 00 00 00 01 00 02 |........|........|
|00001670| 00 01 00 0b 41 47 45 4e | 43 59 20 4e 41 4d 45 db |....AGEN|CY NAME.|
|00001680| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|00001690| 00 00 00 09 00 00 00 00 | 00 00 00 01 00 00 00 a8 |........|........|
|000016a0| 02 24 03 d8 02 70 05 2c | 00 01 00 00 00 00 00 15 |.$...p.,|........|
|000016b0| 00 00 00 0c 00 00 00 03 | 00 03 00 01 00 01 00 04 |........|........|
|000016c0| 00 00 00 00 00 04 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000016d0| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|000016e0| ff ff ff ff ff ff 00 54 | 01 20 00 34 00 30 00 00 |.......T|. .4.0..|
|000016f0| 01 1e 00 0c 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001700| 00 00 00 00 00 00 00 02 | 02 24 04 0c 02 71 05 2d |........|.$...q.-|
|00001710| 01 00 81 81 00 14 00 09 | 00 00 00 00 00 01 00 03 |........|........|
|00001720| 00 01 00 09 54 45 4d 50 | 4f 52 41 52 59 db 00 00 |....TEMP|ORARY...|
|00001730| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00001740| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 a4 02 24 |........|.......$|
|00001750| 06 b8 02 70 08 0c 00 01 | 00 00 00 00 00 15 00 00 |...p....|........|
|00001760| 00 0c 00 00 00 03 00 03 | 00 01 00 01 00 04 00 00 |........|........|
|00001770| 00 00 00 04 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001780| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|00001790| ff ff ff ff 00 54 01 20 | 00 34 00 30 00 00 01 1f |.....T. |.4.0....|
|000017a0| 00 0e 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000017b0| 00 00 00 00 00 02 02 24 | 06 ec 02 71 08 0d 01 00 |.......$|...q....|
|000017c0| 81 81 00 14 00 09 00 00 | 00 00 00 01 00 03 00 01 |........|........|
|000017d0| 00 05 4f 54 48 45 52 b6 | 00 00 00 16 00 01 00 00 |..OTHER.|........|
|000017e0| 00 00 00 0b 00 08 00 14 | 00 00 00 09 00 00 00 00 |........|........|
|000017f0| 00 00 00 01 00 00 00 a8 | 02 70 06 b8 02 b8 08 f2 |........|.p......|
|00001800| 00 01 00 00 00 00 00 15 | 00 00 00 0c 00 00 00 03 |........|........|
|00001810| 00 02 00 00 00 01 00 02 | 00 00 00 00 00 04 00 01 |........|........|
|00001820| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001830| 00 03 00 03 00 00 ff ff | ff ff ff ff ff ff 00 c0 |........|........|
|00001840| 01 24 00 34 00 30 00 00 | 01 20 00 0f 00 01 00 00 |.$.4.0..|. ......|
|00001850| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 02 |........|........|
|00001860| 02 70 06 b8 02 b9 07 78 | 01 01 81 80 00 14 00 09 |.p.....x|........|
|00001870| 00 00 00 00 00 01 00 02 | 00 01 00 09 28 53 50 45 |........|....(SPE|
|00001880| 43 49 46 59 29 08 00 00 | 00 16 00 01 00 00 00 00 |CIFY)...|........|
|00001890| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|000018a0| 00 01 00 00 00 c4 02 b8 | 00 e4 03 00 08 f2 00 01 |........|........|
|000018b0| 00 00 00 00 00 15 00 00 | 00 0c 00 00 00 03 00 02 |........|........|
|000018c0| 00 00 00 01 00 02 00 00 | 00 00 00 04 00 01 00 00 |........|........|
|000018d0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|000018e0| 00 03 00 00 ff ff ff ff | ff ff ff ff 03 48 01 24 |........|.....H.$|
|000018f0| 00 34 00 30 00 00 01 21 | 00 10 00 01 00 00 00 00 |.4.0...!|........|
|00001900| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 02 b8 |........|........|
|00001910| 00 e4 03 01 04 2c 01 01 | 81 80 00 14 00 09 00 00 |.....,..|........|
|00001920| 00 00 00 01 00 02 00 01 | 00 25 42 55 49 4c 44 49 |........|.%BUILDI|
|00001930| 4e 47 20 41 44 44 52 45 | 53 53 20 57 48 45 52 45 |NG ADDRE|SS WHERE|
|00001940| 20 45 4d 50 4c 4f 59 45 | 45 20 57 4f 52 4b 53 b6 | EMPLOYE|E WORKS.|
|00001950| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|00001960| 00 00 00 09 00 00 00 00 | 00 00 00 01 00 00 00 ac |........|........|
|00001970| 03 34 05 60 03 7c 08 bc | 00 01 00 00 00 00 00 15 |.4.`.|..|........|
|00001980| 00 00 00 0c 00 00 00 03 | 00 02 00 04 00 01 00 02 |........|........|
|00001990| 00 00 00 00 00 04 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|000019a0| 00 00 00 00 00 00 00 00 | 00 03 00 03 00 00 ff ff |........|........|
|000019b0| ff ff ff ff ff ff 01 30 | 01 26 00 34 00 30 00 00 |.......0|.&.4.0..|
|000019c0| 01 24 00 12 00 01 00 00 | 00 00 00 00 00 00 00 00 |.$......|........|
|000019d0| 00 00 00 00 00 00 00 02 | 03 34 05 60 03 7d 06 90 |........|.4.`.}..|
|000019e0| 01 01 81 80 00 14 00 09 | 00 00 00 00 00 01 00 02 |........|........|
|000019f0| 00 01 00 0e 54 49 4d 45 | 20 4f 46 20 49 4e 4a 55 |....TIME| OF INJU|
|00001a00| 52 59 00 00 00 16 00 01 | 00 00 00 00 00 0b 00 08 |RY......|........|
|00001a10| 00 14 00 00 00 09 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|00001a20| 00 ac 03 34 00 e4 03 7c | 04 40 00 01 00 00 00 00 |...4...||.@......|
|00001a30| 00 15 00 00 00 0c 00 00 | 00 03 00 02 00 00 00 01 |........|........|
|00001a40| 00 02 00 00 00 00 00 04 | 00 01 00 00 00 00 00 00 |........|........|
|00001a50| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 03 00 00 |........|........|
|00001a60| ff ff ff ff ff ff ff ff | 01 30 01 26 00 34 00 30 |........|.0.&.4.0|
|00001a70| 00 00 01 25 00 11 00 01 | 00 00 00 00 00 00 00 00 |...%....|........|
|00001a80| 00 00 00 00 00 00 00 00 | 00 02 03 34 00 e4 03 7d |........|...4...}|
|00001a90| 02 14 01 01 81 80 00 14 | 00 09 00 00 00 00 00 01 |........|........|
|00001aa0| 00 02 00 01 00 0e 44 41 | 54 45 20 4f 46 20 49 4e |......DA|TE OF IN|
|00001ab0| 4a 55 52 59 00 00 00 16 | 00 01 00 00 00 00 00 0b |JURY....|........|
|00001ac0| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 07 |........|........|
|00001ad0| 00 00 00 72 03 94 00 e4 | 03 bf 03 64 00 01 00 00 |...r....|...d....|
|00001ae0| ff ff ff ff ff ff ff ff | 00 01 00 00 00 00 00 00 |........|........|
|00001af0| 00 02 03 94 00 e4 03 bf | 03 64 00 00 00 00 00 14 |........|.d......|
|00001b00| 00 09 00 00 00 00 00 01 | 00 01 00 01 00 1d 57 41 |........|......WA|
|00001b10| 53 20 54 48 45 52 45 20 | 4c 4f 53 54 20 54 49 4d |S THERE |LOST TIM|
|00001b20| 45 20 46 52 4f 4d 20 57 | 4f 52 4b 6d 00 00 00 16 |E FROM W|ORKm....|
|00001b30| 00 01 00 00 00 00 00 0b | 00 08 00 14 00 00 00 09 |........|........|
|00001b40| 00 00 00 00 00 00 00 01 | 00 00 00 a2 03 78 03 74 |........|.....x.t|
|00001b50| 03 bc 04 3c 00 01 00 00 | 00 00 00 15 00 00 00 0c |...<....|........|
|00001b60| 00 00 00 03 00 03 00 01 | 00 01 00 04 00 00 00 00 |........|........|
|00001b70| 00 04 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001b80| 00 00 00 00 00 00 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00001b90| ff ff 00 54 00 94 00 30 | 00 30 00 00 01 26 00 13 |...T...0|.0...&..|
|00001ba0| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001bb0| 00 00 00 02 03 78 03 a8 | 03 bd 04 3d 01 00 81 81 |.....x..|...=....|
|00001bc0| 00 14 00 09 00 00 00 00 | 00 01 00 03 00 01 00 03 |........|........|
|00001bd0| 59 45 53 6d 00 00 00 16 | 00 01 00 00 00 00 00 0b |YESm....|........|
|00001be0| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 01 |........|........|
|00001bf0| 00 00 00 a0 03 78 04 44 | 03 c4 05 34 00 01 00 00 |.....x.D|...4....|
|00001c00| 00 00 00 15 00 00 00 0c | 00 00 00 03 00 03 00 01 |........|........|
|00001c10| 00 01 00 04 00 00 00 00 | 00 00 00 01 00 00 00 00 |........|........|
|00001c20| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|00001c30| 00 00 ff ff ff ff ff ff | ff ff 00 54 00 b8 00 34 |........|...T...4|
|00001c40| 00 30 00 00 01 27 00 14 | 00 01 00 00 00 00 00 00 |.0...'..|........|
|00001c50| 00 00 00 00 00 00 00 00 | 00 00 00 02 03 78 04 7c |........|.....x.||
|00001c60| 03 c5 05 35 01 00 81 81 | 00 14 00 09 00 00 00 00 |...5....|........|
|00001c70| 00 01 00 03 00 01 00 02 | 4e 4f 00 00 00 16 00 01 |........|NO......|
|00001c80| 00 00 00 00 00 0b 00 08 | 00 14 00 00 00 09 00 00 |........|........|
|00001c90| 00 00 00 00 00 01 00 00 | 00 b4 03 78 05 60 03 bf |........|...x.`..|
|00001ca0| 08 bc 00 01 00 00 00 00 | 00 15 00 00 00 0c 00 00 |........|........|
|00001cb0| 00 03 00 02 00 00 00 01 | 00 02 00 00 00 00 00 04 |........|........|
|00001cc0| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001cd0| 00 00 00 03 00 03 00 00 | ff ff ff ff ff ff ff ff |........|........|
|00001ce0| 01 ec 01 26 00 33 00 30 | 00 00 01 28 00 15 00 01 |...&.3.0|...(....|
|00001cf0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001d00| 00 02 03 78 05 60 03 c0 | 07 4c 01 01 81 80 00 14 |...x.`..|.L......|
|00001d10| 00 09 00 00 00 00 00 01 | 00 02 00 01 00 16 4e 55 |........|......NU|
|00001d20| 4d 42 45 52 20 4f 46 20 | 48 4f 55 52 53 20 4d 49 |MBER OF |HOURS MI|
|00001d30| 53 53 45 44 00 00 00 16 | 00 01 00 00 00 00 00 0b |SSED....|........|
|00001d40| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 01 |........|........|
|00001d50| 00 00 00 b4 03 b4 00 e4 | 03 fc 04 2c 00 01 00 00 |........|...,....|
|00001d60| 00 00 00 15 00 00 00 0c | 00 00 00 03 00 02 00 00 |........|........|
|00001d70| 00 01 00 02 00 00 00 00 | 00 04 00 01 00 00 00 00 |........|........|
|00001d80| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 03 00 03 |........|........|
|00001d90| 00 00 ff ff ff ff ff ff | ff ff 01 f4 01 26 00 34 |........|.....&.4|
|00001da0| 00 30 00 00 01 29 00 16 | 00 01 00 00 00 00 00 00 |.0...)..|........|
|00001db0| 00 00 00 00 00 00 00 00 | 00 00 00 02 03 b4 00 e4 |........|........|
|00001dc0| 03 fd 02 d8 01 01 81 80 | 00 14 00 09 00 00 00 00 |........|........|
|00001dd0| 00 01 00 02 00 01 00 15 | 44 41 54 45 20 52 45 54 |........|DATE RET|
|00001de0| 55 52 4e 45 44 20 54 4f | 20 57 4f 52 4b b6 00 00 |URNED TO| WORK...|
|00001df0| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00001e00| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 c6 03 f4 |........|........|
|00001e10| 00 e4 04 3c 08 bc 00 01 | 00 00 00 00 00 15 00 00 |...<....|........|
|00001e20| 00 0c 00 00 00 03 00 02 | 00 00 00 01 00 02 00 00 |........|........|
|00001e30| 00 00 00 04 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001e40| 00 00 00 00 00 00 00 03 | 00 03 00 00 ff ff ff ff |........|........|
|00001e50| ff ff ff ff 03 7c 01 26 | 00 34 00 30 00 00 01 2a |.....|.&|.4.0...*|
|00001e60| 00 17 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001e70| 00 00 00 00 00 02 03 f4 | 00 e4 04 3d 04 60 01 01 |........|...=.`..|
|00001e80| 81 80 00 14 00 09 00 00 | 00 00 00 01 00 02 00 01 |........|........|
|00001e90| 00 28 41 44 44 52 45 53 | 53 2f 4c 4f 43 41 54 49 |.(ADDRES|S/LOCATI|
|00001ea0| 4f 4e 20 57 48 45 52 45 | 20 49 4e 43 49 44 45 4e |ON WHERE| INCIDEN|
|00001eb0| 54 20 4f 43 43 55 52 52 | 45 44 00 00 00 16 00 01 |T OCCURR|ED......|
|00001ec0| 00 00 00 00 00 0b 00 08 | 00 14 00 00 00 09 00 00 |........|........|
|00001ed0| 00 00 00 00 00 01 00 00 | 00 d6 04 3c 00 e4 04 84 |........|...<....|
|00001ee0| 08 bc 00 01 00 00 00 00 | 00 15 00 00 00 0c 00 00 |........|........|
|00001ef0| 00 03 00 02 00 00 00 01 | 00 02 00 00 00 00 00 04 |........|........|
|00001f00| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001f10| 00 00 00 03 00 03 00 00 | ff ff ff ff ff ff ff ff |........|........|
|00001f20| 04 c0 01 26 00 34 00 30 | 00 00 01 2b 00 18 00 01 |...&.4.0|...+....|
|00001f30| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00001f40| 00 02 04 3c 00 e4 04 85 | 05 a4 01 01 81 80 00 14 |...<....|........|
|00001f50| 00 09 00 00 00 00 00 01 | 00 02 00 01 00 37 57 48 |........|.....7WH|
|00001f60| 41 54 20 57 41 53 20 54 | 48 45 20 45 4d 50 4c 4f |AT WAS T|HE EMPLO|
|00001f70| 59 45 45 20 44 4f 49 4e | 47 20 57 48 45 4e 20 54 |YEE DOIN|G WHEN T|
|00001f80| 48 45 20 49 4e 43 49 44 | 45 4e 54 20 4f 43 43 55 |HE INCID|ENT OCCU|
|00001f90| 52 52 45 44 3f 14 00 00 | 00 16 00 01 00 00 00 00 |RRED?...|........|
|00001fa0| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|00001fb0| 00 07 00 00 00 ba 04 98 | 00 e4 04 c0 08 00 00 01 |........|........|
|00001fc0| 00 00 ff ff ff ff ff ff | ff ff 00 01 00 00 00 00 |........|........|
|00001fd0| 00 00 00 02 04 98 00 e4 | 04 c0 08 00 00 00 00 00 |........|........|
|00001fe0| 00 14 00 09 00 00 00 00 | 00 01 00 01 00 01 00 65 |........|.......e|
|00001ff0| 44 45 53 43 52 49 42 45 | 20 54 48 45 20 45 56 45 |DESCRIBE| THE EVE|
|00002000| 4e 54 53 20 54 48 41 54 | 20 4f 43 43 55 52 52 45 |NTS THAT| OCCURRE|
|00002010| 44 20 44 55 52 49 4e 47 | 20 54 48 45 20 49 4e 43 |D DURING| THE INC|
|00002020| 49 44 45 4e 54 20 28 61 | 74 74 61 63 68 20 61 64 |IDENT (a|ttach ad|
|00002030| 64 69 74 69 6f 6e 61 6c | 20 64 6f 63 75 6d 65 6e |ditional| documen|
|00002040| 74 61 74 69 6f 6e 20 69 | 66 20 6e 65 63 65 73 73 |tation i|f necess|
|00002050| 61 72 79 29 3a 00 00 00 | 00 16 00 01 00 00 00 00 |ary):...|........|
|00002060| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|00002070| 00 01 00 00 00 a4 04 c8 | 00 ec 05 70 08 bc 00 01 |........|...p....|
|00002080| 00 00 00 00 00 15 00 00 | 00 0c 00 00 00 01 00 01 |........|........|
|00002090| 00 00 00 00 00 02 00 00 | 00 00 00 04 00 01 00 00 |........|........|
|000020a0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|000020b0| 00 03 00 00 ff ff ff ff | ff ff ff ff 01 f4 01 26 |........|.......&|
|000020c0| 00 34 00 30 00 00 01 2c | 00 19 00 01 00 00 00 00 |.4.0...,|........|
|000020d0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 05 71 |........|.......q|
|000020e0| 00 ec 05 71 08 bd 01 01 | 81 80 00 14 00 09 00 00 |...q....|........|
|000020f0| 00 00 00 01 00 02 00 01 | 00 05 46 69 65 6c 64 db |........|..Field.|
|00002100| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|00002110| 00 00 00 09 00 00 00 00 | 00 00 00 01 00 00 00 d4 |........|........|
|00002120| 05 70 00 e4 05 b8 08 bc | 00 01 00 00 00 00 00 15 |.p......|........|
|00002130| 00 00 00 0c 00 00 00 03 | 00 02 00 00 00 01 00 02 |........|........|
|00002140| 00 00 00 00 00 04 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00002150| 00 00 00 00 00 00 00 00 | 00 03 00 03 00 00 ff ff |........|........|
|00002160| ff ff ff ff ff ff 03 5c | 01 26 00 34 00 30 00 00 |.......\|.&.4.0..|
|00002170| 01 2d 00 1a 00 01 00 00 | 00 00 00 00 00 00 00 00 |.-......|........|
|00002180| 00 00 00 00 00 00 00 02 | 05 70 00 e4 05 b9 04 40 |........|.p.....@|
|00002190| 01 01 81 80 00 14 00 09 | 00 00 00 00 00 01 00 02 |........|........|
|000021a0| 00 01 00 35 54 59 50 45 | 20 4f 46 20 49 4e 4a 55 |...5TYPE| OF INJU|
|000021b0| 52 59 2f 49 4c 4c 4e 45 | 53 53 20 28 73 63 72 61 |RY/ILLNE|SS (scra|
|000021c0| 74 63 68 2c 20 70 75 6e | 63 74 75 72 65 2c 20 63 |tch, pun|cture, c|
|000021d0| 75 74 2c 20 65 74 63 2e | 29 08 00 00 00 16 00 01 |ut, etc.|).......|
|000021e0| 00 00 00 00 00 0b 00 08 | 00 14 00 00 00 09 00 00 |........|........|
|000021f0| 00 00 00 00 00 01 00 00 | 00 e2 05 b8 00 e4 06 00 |........|........|
|00002200| 08 bc 00 01 00 00 00 00 | 00 15 00 00 00 0c 00 00 |........|........|
|00002210| 00 03 00 02 00 00 00 01 | 00 02 00 00 00 00 00 04 |........|........|
|00002220| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002230| 00 00 00 03 00 03 00 00 | ff ff ff ff ff ff ff ff |........|........|
|00002240| 04 54 01 26 00 34 00 30 | 00 00 01 2e 00 1b 00 01 |.T.&.4.0|........|
|00002250| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002260| 00 02 05 b8 00 e4 06 01 | 05 38 01 01 81 80 00 14 |........|.8......|
|00002270| 00 09 00 00 00 00 00 01 | 00 02 00 01 00 43 50 41 |........|.....CPA|
|00002280| 52 54 20 4f 46 20 42 4f | 44 59 20 49 4e 4a 55 52 |RT OF BO|DY INJUR|
|00002290| 45 44 2f 41 46 46 45 43 | 54 45 44 20 28 6c 65 66 |ED/AFFEC|TED (lef|
|000022a0| 74 20 72 69 6e 67 20 66 | 69 6e 67 65 72 2c 20 72 |t ring f|inger, r|
|000022b0| 69 67 68 74 20 61 6e 6b | 6c 65 2c 20 65 74 63 2e |ight ank|le, etc.|
|000022c0| 29 db 00 00 00 16 00 01 | 00 00 00 00 00 0b 00 08 |).......|........|
|000022d0| 00 14 00 00 00 09 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|000022e0| 00 e6 06 00 00 e4 06 48 | 08 bc 00 01 00 00 00 00 |.......H|........|
|000022f0| 00 15 00 00 00 0c 00 00 | 00 03 00 02 00 00 00 01 |........|........|
|00002300| 00 02 00 00 00 00 00 04 | 00 01 00 00 00 00 00 00 |........|........|
|00002310| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 03 00 00 |........|........|
|00002320| ff ff ff ff ff ff ff ff | 05 c8 01 26 00 34 00 30 |........|...&.4.0|
|00002330| 00 00 01 2f 00 1c 00 01 | 00 00 00 00 00 00 00 00 |.../....|........|
|00002340| 00 00 00 00 00 00 00 00 | 00 02 06 00 00 e4 06 49 |........|.......I|
|00002350| 06 ac 01 01 81 80 00 14 | 00 09 00 00 00 00 00 01 |........|........|
|00002360| 00 02 00 01 00 47 53 50 | 45 43 49 46 59 20 50 49 |.....GSP|ECIFY PI|
|00002370| 45 43 45 20 4f 46 20 45 | 51 55 49 50 4d 45 4e 54 |ECE OF E|QUIPMENT|
|00002380| 2c 20 53 55 42 53 54 41 | 4e 43 45 20 4f 52 20 4f |, SUBSTA|NCE OR O|
|00002390| 42 4a 45 43 54 20 43 4f | 4e 4e 45 43 54 45 44 20 |BJECT CO|NNECTED |
|000023a0| 57 49 54 48 20 49 4e 43 | 49 44 45 4e 54 2c 00 00 |WITH INC|IDENT,..|
|000023b0| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|000023c0| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 ae 06 90 |........|........|
|000023d0| 00 e4 06 d8 08 bc 00 01 | 00 00 00 00 00 15 00 00 |........|........|
|000023e0| 00 0c 00 00 00 03 00 02 | 00 00 00 01 00 02 00 00 |........|........|
|000023f0| 00 00 00 04 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002400| 00 00 00 00 00 00 00 03 | 00 03 00 00 ff ff ff ff |........|........|
|00002410| ff ff ff ff 01 54 01 26 | 00 34 00 30 00 00 01 31 |.....T.&|.4.0...1|
|00002420| 00 1f 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002430| 00 00 00 00 00 02 06 90 | 00 e4 06 d9 02 38 01 01 |........|.....8..|
|00002440| 81 80 00 14 00 09 00 00 | 00 00 00 01 00 02 00 01 |........|........|
|00002450| 00 10 4c 49 53 54 20 41 | 4e 59 20 57 49 54 4e 45 |..LIST A|NY WITNE|
|00002460| 53 53 00 00 00 16 00 01 | 00 00 00 00 00 0b 00 08 |SS......|........|
|00002470| 00 14 00 00 00 09 00 00 | 00 00 00 00 00 0d 00 00 |........|........|
|00002480| 00 88 07 24 00 b0 08 74 | 09 20 00 00 00 02 00 02 |...$...t|. ......|
|00002490| 00 02 00 02 00 02 00 03 | 00 00 00 34 07 3c 00 b0 |........|...4.<..|
|000024a0| 08 74 09 0c 00 01 00 00 | 00 03 00 00 ff ff ff ff |.t......|........|
|000024b0| ff ff ff ff 00 00 aa 55 | aa 55 aa 55 aa 55 00 01 |.......U|.U.U.U..|
|000024c0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000024d0| 00 03 00 00 00 34 07 24 | 00 c4 08 5c 09 20 00 01 |.....4.$|...\. ..|
|000024e0| 00 00 00 03 00 00 ff ff | ff ff ff ff ff ff 00 00 |........|........|
|000024f0| 00 00 00 00 00 00 00 00 | 00 01 00 00 00 00 00 00 |........|........|
|00002500| 00 00 00 00 00 00 00 00 | 00 00 00 07 00 00 00 68 |........|.......h|
|00002510| 07 44 00 e4 07 6f 02 e8 | 00 01 00 00 ff ff ff ff |.D...o..|........|
|00002520| ff ff ff ff 00 01 00 00 | 00 00 00 00 00 02 07 44 |........|.......D|
|00002530| 00 e4 07 6f 02 e8 00 00 | 00 00 00 14 00 09 00 00 |...o....|........|
|00002540| 00 00 00 01 00 01 00 01 | 00 14 57 41 53 20 46 49 |........|..WAS FI|
|00002550| 52 53 54 20 41 49 44 20 | 47 49 56 45 4e 3f 00 00 |RST AID |GIVEN?..|
|00002560| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00002570| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 a2 07 28 |........|.......(|
|00002580| 02 b4 07 74 03 38 00 01 | 00 00 00 00 00 15 00 00 |...t.8..|........|
|00002590| 00 0c 00 00 00 03 00 03 | 00 01 00 01 00 04 00 00 |........|........|
|000025a0| 00 00 00 04 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000025b0| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|000025c0| ff ff ff ff 00 54 00 58 | 00 34 00 30 00 00 01 32 |.....T.X|.4.0...2|
|000025d0| 00 20 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |. ......|........|
|000025e0| 00 00 00 00 00 02 07 28 | 02 e0 07 75 03 39 01 00 |.......(|...u.9..|
|000025f0| 81 81 00 14 00 09 00 00 | 00 00 00 01 00 03 00 01 |........|........|
|00002600| 00 03 59 45 53 00 00 00 | 00 16 00 01 00 00 00 00 |..YES...|........|
|00002610| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|00002620| 00 01 00 00 00 a0 07 2c | 03 8c 07 78 04 7c 00 01 |.......,|...x.|..|
|00002630| 00 00 00 00 00 15 00 00 | 00 0c 00 00 00 03 00 03 |........|........|
|00002640| 00 01 00 01 00 04 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|00002650| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002660| 00 03 00 00 ff ff ff ff | ff ff ff ff 00 54 00 c0 |........|.....T..|
|00002670| 00 34 00 30 00 00 01 33 | 00 21 00 01 00 00 00 00 |.4.0...3|.!......|
|00002680| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 07 2c |........|.......,|
|00002690| 03 bc 07 79 04 7d 01 00 | 81 81 00 14 00 09 00 00 |...y.}..|........|
|000026a0| 00 00 00 01 00 03 00 01 | 00 02 4e 4f 00 00 00 16 |........|..NO....|
|000026b0| 00 01 00 00 00 00 00 0b | 00 08 00 14 00 00 00 09 |........|........|
|000026c0| 00 00 00 00 00 00 00 07 | 00 00 00 70 07 44 05 20 |........|...p.D. |
|000026d0| 07 6f 07 70 00 01 00 00 | ff ff ff ff ff ff ff ff |.o.p....|........|
|000026e0| 00 01 00 00 00 00 00 00 | 00 02 07 44 05 20 07 6f |........|...D. .o|
|000026f0| 07 70 00 00 00 00 00 14 | 00 09 00 00 00 00 00 01 |.p......|........|
|00002700| 00 01 00 01 00 1c 52 45 | 46 45 52 52 45 44 20 54 |......RE|FERRED T|
|00002710| 4f 20 43 4c 49 4e 49 43 | 20 4f 52 20 44 4f 43 54 |O CLINIC| OR DOCT|
|00002720| 4f 52 00 00 00 16 00 01 | 00 00 00 00 00 0b 00 08 |OR......|........|
|00002730| 00 14 00 00 00 09 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|00002740| 00 a2 07 30 07 80 07 70 | 08 0c 00 01 00 00 00 00 |...0...p|........|
|00002750| 00 15 00 00 00 0c 00 00 | 00 03 00 03 00 01 00 01 |........|........|
|00002760| 00 04 00 00 00 00 00 04 | 00 00 00 00 00 00 00 00 |........|........|
|00002770| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 03 00 00 |........|........|
|00002780| ff ff ff ff ff ff ff ff | 00 54 00 58 00 2c 00 2c |........|.T.X.,.,|
|00002790| 00 00 01 34 00 22 00 01 | 00 00 00 00 00 00 00 00 |...4."..|........|
|000027a0| 00 00 00 00 00 00 00 00 | 00 02 07 30 07 b4 07 71 |........|...0...q|
|000027b0| 08 0d 01 00 81 81 00 14 | 00 09 00 00 00 00 00 01 |........|........|
|000027c0| 00 03 00 01 00 03 59 45 | 53 00 00 00 00 16 00 01 |......YE|S.......|
|000027d0| 00 00 00 00 00 0b 00 08 | 00 14 00 00 00 09 00 00 |........|........|
|000027e0| 00 00 00 00 00 01 00 00 | 00 a0 07 2c 08 1c 07 78 |........|...,...x|
|000027f0| 09 0c 00 01 00 00 00 00 | 00 15 00 00 00 0c 00 00 |........|........|
|00002800| 00 03 00 03 00 01 00 01 | 00 04 00 00 00 00 00 00 |........|........|
|00002810| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002820| 00 00 00 00 00 03 00 00 | ff ff ff ff ff ff ff ff |........|........|
|00002830| 00 54 00 c0 00 34 00 30 | 00 00 01 35 00 23 00 01 |.T...4.0|...5.#..|
|00002840| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002850| 00 02 07 2c 08 4c 07 79 | 09 0d 01 00 81 81 00 14 |...,.L.y|........|
|00002860| 00 09 00 00 00 00 00 01 | 00 03 00 01 00 02 4e 4f |........|......NO|
|00002870| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|00002880| 00 00 00 09 00 00 00 00 | 00 00 00 07 00 00 00 74 |........|.......t|
|00002890| 07 88 00 e4 07 b3 03 58 | 00 01 00 00 ff ff ff ff |.......X|........|
|000028a0| ff ff ff ff 00 01 00 00 | 00 00 00 00 00 02 07 88 |........|........|
|000028b0| 00 e4 07 b3 03 58 00 00 | 00 00 00 14 00 09 00 00 |.....X..|........|
|000028c0| 00 00 00 01 00 01 00 01 | 00 1f 4e 41 4d 45 20 4f |........|..NAME O|
|000028d0| 46 20 43 4c 49 4e 49 43 | 20 41 4e 44 20 2f 20 4f |F CLINIC| AND / O|
|000028e0| 52 20 44 4f 43 54 4f 52 | 3a 10 00 00 00 16 00 01 |R DOCTOR|:.......|
|000028f0| 00 00 00 00 00 0b 00 08 | 00 14 00 00 00 09 00 00 |........|........|
|00002900| 00 00 00 00 00 01 00 00 | 00 a4 07 c4 00 ec 08 30 |........|.......0|
|00002910| 08 bc 00 01 00 00 00 00 | 00 15 00 00 00 0c 00 00 |........|........|
|00002920| 00 01 00 01 00 00 00 00 | 00 02 00 00 00 00 00 04 |........|........|
|00002930| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002940| 00 00 00 03 00 03 00 00 | ff ff ff ff ff ff ff ff |........|........|
|00002950| 01 f4 01 26 00 34 00 30 | 00 00 01 36 00 24 00 01 |...&.4.0|...6.$..|
|00002960| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002970| 00 02 08 31 00 ec 08 31 | 08 bd 01 01 81 80 00 14 |...1...1|........|
|00002980| 00 09 00 00 00 00 00 01 | 00 02 00 01 00 05 46 69 |........|......Fi|
|00002990| 65 6c 64 6d 00 00 00 16 | 00 01 00 00 00 00 00 0b |eldm....|........|
|000029a0| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 0d |........|........|
|000029b0| 00 00 00 88 08 88 00 b0 | 09 d8 09 20 00 00 00 02 |........|... ....|
|000029c0| 00 02 00 02 00 02 00 02 | 00 03 00 00 00 34 08 a0 |........|.....4..|
|000029d0| 00 b0 09 d8 09 0b 00 01 | 00 00 00 03 00 00 ff ff |........|........|
|000029e0| ff ff ff ff ff ff 00 00 | aa 55 aa 55 aa 55 aa 55 |........|.U.U.U.U|
|000029f0| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002a00| 00 00 00 03 00 00 00 34 | 08 88 00 c3 09 c0 09 20 |.......4|....... |
|00002a10| 00 01 00 00 00 03 00 00 | ff ff ff ff ff ff ff ff |........|........|
|00002a20| 00 00 00 00 00 00 00 00 | 00 00 00 01 00 00 00 00 |........|........|
|00002a30| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 07 00 00 |........|........|
|00002a40| 00 90 08 a4 00 e4 08 cf | 06 00 00 01 00 00 ff ff |........|........|
|00002a50| ff ff ff ff ff ff 00 01 | 00 00 00 00 00 00 00 02 |........|........|
|00002a60| 08 a4 00 e4 08 cf 06 00 | 00 00 00 00 00 14 00 09 |........|........|
|00002a70| 00 00 00 00 00 01 00 01 | 00 01 00 3b 48 41 53 20 |........|...;HAS |
|00002a80| 54 48 49 53 20 49 4e 43 | 49 44 45 4e 54 20 42 45 |THIS INC|IDENT BE|
|00002a90| 45 4e 20 44 49 53 43 55 | 53 53 45 44 20 57 49 54 |EN DISCU|SSED WIT|
|00002aa0| 48 20 54 48 45 20 45 4d | 50 4c 4f 59 45 45 20 49 |H THE EM|PLOYEE I|
|00002ab0| 4e 56 4f 4c 56 45 44 09 | 00 00 00 16 00 01 00 00 |NVOLVED.|........|
|00002ac0| 00 00 00 0b 00 08 00 14 | 00 00 00 09 00 00 00 00 |........|........|
|00002ad0| 00 00 00 01 00 00 00 a2 | 08 94 05 d4 08 dc 06 90 |........|........|
|00002ae0| 00 01 00 00 00 00 00 15 | 00 00 00 0c 00 00 00 03 |........|........|
|00002af0| 00 03 00 01 00 01 00 04 | 00 00 00 00 00 00 00 01 |........|........|
|00002b00| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002b10| 00 00 00 03 00 00 ff ff | ff ff ff ff ff ff 00 54 |........|.......T|
|00002b20| 00 8c 00 34 00 30 00 00 | 01 37 00 25 00 01 00 00 |...4.0..|.7.%....|
|00002b30| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 02 |........|........|
|00002b40| 08 94 06 04 08 dd 06 91 | 01 00 81 81 00 14 00 09 |........|........|
|00002b50| 00 00 00 00 00 01 00 03 | 00 01 00 03 59 45 53 00 |........|....YES.|
|00002b60| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|00002b70| 00 00 00 09 00 00 00 00 | 00 00 00 01 00 00 00 a0 |........|........|
|00002b80| 08 90 06 a4 08 dc 07 94 | 00 01 00 00 00 00 00 15 |........|........|
|00002b90| 00 00 00 0c 00 00 00 03 | 00 03 00 01 00 01 00 04 |........|........|
|00002ba0| 00 00 00 00 00 00 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00002bb0| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|00002bc0| ff ff ff ff ff ff 00 54 | 00 c0 00 34 00 30 00 00 |.......T|...4.0..|
|00002bd0| 01 38 00 26 00 01 00 00 | 00 00 00 00 00 00 00 00 |.8.&....|........|
|00002be0| 00 00 00 00 00 00 00 02 | 08 90 06 d4 08 dd 07 95 |........|........|
|00002bf0| 01 00 81 81 00 14 00 09 | 00 00 00 00 00 01 00 03 |........|........|
|00002c00| 00 01 00 02 4e 4f 00 00 | 00 16 00 01 00 00 00 00 |....NO..|........|
|00002c10| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|00002c20| 00 07 00 00 00 a0 08 e0 | 00 e4 09 0b 07 60 00 01 |........|.....`..|
|00002c30| 00 00 ff ff ff ff ff ff | ff ff 00 01 00 00 00 00 |........|........|
|00002c40| 00 00 00 02 08 e0 00 e4 | 09 0b 07 60 00 00 00 00 |........|...`....|
|00002c50| 00 14 00 09 00 00 00 00 | 00 01 00 01 00 01 00 4c |........|.......L|
|00002c60| 57 48 41 54 20 53 50 45 | 43 49 46 49 43 20 41 43 |WHAT SPE|CIFIC AC|
|00002c70| 54 49 4f 4e 53 20 48 41 | 56 45 20 59 4f 55 20 54 |TIONS HA|VE YOU T|
|00002c80| 41 4b 45 4e 20 54 4f 20 | 50 52 45 56 45 4e 54 20 |AKEN TO |PREVENT |
|00002c90| 54 48 49 53 20 49 4e 43 | 49 44 45 4e 54 20 46 52 |THIS INC|IDENT FR|
|00002ca0| 4f 4d 20 52 45 43 55 52 | 52 49 4e 47 00 00 00 16 |OM RECUR|RING....|
|00002cb0| 00 01 00 00 00 00 00 0b | 00 08 00 14 00 00 00 09 |........|........|
|00002cc0| 00 00 00 00 00 00 00 01 | 00 00 00 a4 09 10 00 ec |........|........|
|00002cd0| 09 b4 08 bc 00 01 00 00 | 00 00 00 15 00 00 00 0c |........|........|
|00002ce0| 00 00 00 01 00 01 00 00 | 00 00 00 02 00 00 00 00 |........|........|
|00002cf0| 00 04 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002d00| 00 00 00 00 00 03 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00002d10| ff ff 01 f4 01 26 00 34 | 00 30 00 00 01 39 00 27 |.....&.4|.0...9.'|
|00002d20| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002d30| 00 00 00 02 09 b5 00 ec | 09 b5 08 bd 01 01 81 80 |........|........|
|00002d40| 00 14 00 09 00 00 00 00 | 00 01 00 02 00 01 00 05 |........|........|
|00002d50| 46 69 65 6c 64 6d 00 00 | 00 16 00 01 00 00 00 00 |Fieldm..|........|
|00002d60| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|00002d70| 00 01 00 00 00 b2 0b 3c | 00 b0 0b 84 05 f8 00 01 |.......<|........|
|00002d80| 00 00 00 00 00 15 00 00 | 00 0c 00 00 00 03 00 02 |........|........|
|00002d90| 00 2a 00 01 00 02 00 00 | 00 00 00 04 00 01 00 00 |.*......|........|
|00002da0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|00002db0| 00 03 00 00 ff ff ff ff | ff ff ff ff 01 f0 01 26 |........|.......&|
|00002dc0| 00 34 00 30 00 00 01 3a | 00 00 00 00 00 00 00 00 |.4.0...:|........|
|00002dd0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 0b 3c |........|.......<|
|00002de0| 00 b0 0b 85 02 a0 01 01 | 81 80 00 14 00 0a 00 00 |........|........|
|00002df0| 00 00 00 01 00 02 00 01 | 00 14 53 55 50 45 52 56 |........|..SUPERV|
|00002e00| 49 53 4f 52 20 53 49 47 | 4e 41 54 55 52 45 00 00 |ISOR SIG|NATURE..|
|00002e10| 00 16 00 01 00 00 00 00 | 00 0c 00 09 00 14 00 00 |........|........|
|00002e20| 00 0a 00 00 00 00 00 00 | 00 01 00 00 00 aa 0b 3c |........|.......<|
|00002e30| 06 38 0b 84 09 20 00 01 | 00 00 00 00 00 15 00 00 |.8... ..|........|
|00002e40| 00 0c 00 00 00 03 00 02 | 00 00 00 01 00 02 00 00 |........|........|
|00002e50| 00 00 00 04 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002e60| 00 00 00 00 00 00 00 03 | 00 03 00 00 ff ff ff ff |........|........|
|00002e70| ff ff ff ff 01 2e 01 26 | 00 34 00 24 00 00 01 3b |.......&|.4.$...;|
|00002e80| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002e90| 00 00 00 00 00 02 0b 3c | 06 38 0b 85 07 66 01 01 |.......<|.8...f..|
|00002ea0| 81 80 00 14 00 0a 00 00 | 00 00 00 01 00 02 00 01 |........|........|
|00002eb0| 00 0b 44 41 54 45 20 53 | 49 47 4e 45 44 b6 00 00 |..DATE S|IGNED...|
|00002ec0| 00 16 00 01 00 00 00 00 | 00 0c 00 09 00 14 00 00 |........|........|
|00002ed0| 00 0a 00 00 00 00 00 00 | 00 06 00 00 01 ae 07 00 |........|........|
|00002ee0| 00 70 08 44 00 a8 00 01 | 00 00 07 00 00 70 08 44 |.p.D....|.....p.D|
|00002ef0| 00 a8 00 30 00 28 01 74 | 00 60 00 00 00 00 01 7b |...0.(.t|.`.....{|
|00002f00| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002f10| 01 7b ff ff ff ff 00 50 | 00 0d 11 01 a0 00 82 a1 |.{.....P|........|
|00002f20| 00 96 00 0c 01 00 01 0e | 02 00 01 0e 00 00 00 00 |........|........|
|00002f30| a1 00 9a 00 08 ff fd 00 | 00 00 27 00 00 03 00 14 |........|..'.....|
|00002f40| 04 01 0d 00 0a 28 00 2b | ff e0 09 54 52 45 41 54 |.....(.+|...TREAT|
|00002f50| 4d 45 4e 54 01 00 0a 00 | 00 00 00 00 4f 00 0c 90 |MENT....|....O...|
|00002f60| 00 04 00 00 00 00 00 42 | 00 20 00 00 00 00 00 42 |.......B|. .....B|
|00002f70| 00 20 00 0d 00 00 00 4f | 00 20 00 01 00 00 00 00 |. .....O|. ......|
|00002f80| 00 00 00 00 18 00 00 00 | 18 40 00 00 1f c0 00 00 |........|.@......|
|00002f90| 1f c0 00 00 18 40 00 00 | 18 00 00 00 1f c0 00 00 |.....@..|........|
|00002fa0| 1f c0 00 00 13 00 00 00 | 06 40 00 00 1f c0 00 00 |........|.@......|
|00002fb0| 1f c0 00 00 10 40 00 00 | 00 00 00 00 18 c0 00 00 |.....@..|........|
|00002fc0| 1a c0 00 00 12 40 00 00 | 1f c0 00 00 1f c0 00 00 |.....@..|........|
|00002fd0| 10 40 00 00 10 40 00 00 | 1f c0 00 00 1f c0 00 00 |.@...@..|........|
|00002fe0| 1e 40 00 00 07 80 00 00 | 07 80 00 00 1e 40 00 00 |.@......|.....@..|
|00002ff0| 1f c0 00 00 1f c0 00 00 | 10 40 00 00 18 00 00 00 |........|.@......|
|00003000| 18 40 00 00 1f c0 00 00 | 1f c0 00 00 18 40 00 00 |.@......|.....@..|
|00003010| 18 40 00 00 01 c0 00 00 | 07 c0 00 00 1f 40 00 00 |.@......|.....@..|
|00003020| 1f 40 00 00 07 c0 00 00 | 01 c0 00 00 00 40 00 00 |.@......|.....@..|
|00003030| 00 00 00 00 18 c0 00 00 | 1a c0 00 00 12 40 00 00 |........|.....@..|
|00003040| 1f c0 00 00 1f c0 00 00 | 10 40 00 00 0c 40 00 00 |........|.@...@..|
|00003050| 1e c0 00 00 13 c0 00 00 | 13 40 00 00 1f c0 00 00 |........|.@......|
|00003060| 1f c0 00 00 10 40 00 00 | 00 00 00 00 18 00 00 00 |.....@..|........|
|00003070| 18 40 00 00 1f c0 00 00 | 1f c0 00 00 18 40 00 00 |.@......|.....@..|
|00003080| 18 00 00 00 a0 00 97 a0 | 00 83 ff 07 00 06 00 00 |........|........|
|00003090| 01 b6 08 6c 00 70 09 b8 | 00 a8 00 01 00 00 08 6c |...l.p..|.......l|
|000030a0| 00 70 09 b8 00 a8 00 30 | 00 28 01 7c 00 60 00 00 |.p.....0|.(.|.`..|
|000030b0| 00 00 01 84 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000030c0| 00 00 00 00 01 84 ff ff | ff ff 00 52 00 0d 11 01 |........|...R....|
|000030d0| a0 00 82 a1 00 96 00 0c | 01 00 01 0e 02 00 01 0e |........|........|
|000030e0| 00 00 00 00 a1 00 9a 00 | 08 ff fc 00 00 00 27 00 |........|......'.|
|000030f0| 00 03 00 14 04 01 0d 00 | 0a 28 00 2c ff df 0a 50 |........|.(.,...P|
|00003100| 52 45 56 45 4e 54 49 4f | 4e 01 00 0a 00 00 00 00 |REVENTIO|N.......|
|00003110| 00 51 00 0c 90 00 04 00 | 00 00 00 00 44 00 20 00 |.Q......|....D. .|
|00003120| 00 00 00 00 44 00 20 00 | 0d 00 00 00 51 00 20 00 |....D. .|....Q. .|
|00003130| 01 00 00 00 00 10 00 00 | 00 1f c0 00 00 1f c0 00 |........|........|
|00003140| 00 13 00 00 00 06 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00003150| 00 10 40 00 00 07 00 00 | 00 0f 80 00 00 18 c0 00 |..@.....|........|
|00003160| 00 10 40 00 00 18 c0 00 | 00 0f 80 00 00 07 00 00 |..@.....|........|
|00003170| 00 10 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00003180| 00 00 00 00 00 18 00 00 | 00 18 40 00 00 1f c0 00 |........|..@.....|
|00003190| 00 1f c0 00 00 18 40 00 | 00 18 00 00 00 1f c0 00 |......@.|........|
|000031a0| 00 1f c0 00 00 13 00 00 | 00 06 40 00 00 1f c0 00 |........|..@.....|
|000031b0| 00 1f c0 00 00 10 40 00 | 00 00 00 00 00 18 c0 00 |......@.|........|
|000031c0| 00 1a c0 00 00 12 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|000031d0| 00 10 40 00 00 1c 00 00 | 00 1f 00 00 00 13 c0 00 |..@.....|........|
|000031e0| 00 13 c0 00 00 1f 00 00 | 00 1c 00 00 00 10 00 00 |........|........|
|000031f0| 00 00 00 00 00 18 c0 00 | 00 1a c0 00 00 12 40 00 |........|......@.|
|00003200| 00 1f c0 00 00 1f c0 00 | 00 10 40 00 00 0c 40 00 |........|..@...@.|
|00003210| 00 1e c0 00 00 13 c0 00 | 00 13 40 00 00 1f c0 00 |........|..@.....|
|00003220| 00 1f c0 00 00 10 40 00 | 00 0c 00 00 00 1e 00 00 |......@.|........|
|00003230| 00 12 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00003240| 00 a0 00 97 a0 00 83 ff | 00 07 00 00 00 72 06 64 |........|.....r.d|
|00003250| 00 e4 06 8f 03 34 00 01 | 00 00 ff ff ff ff ff ff |.....4..|........|
|00003260| ff ff 00 01 00 00 00 00 | 00 00 00 02 06 64 00 e4 |........|.....d..|
|00003270| 06 8f 03 34 00 00 00 00 | 00 14 00 09 00 00 00 00 |...4....|........|
|00003280| 00 01 00 01 00 01 00 1d | 44 49 44 20 59 4f 55 20 |........|DID YOU |
|00003290| 57 49 54 4e 45 53 53 20 | 54 48 49 53 20 49 4e 43 |WITNESS |THIS INC|
|000032a0| 49 44 45 4e 54 64 00 00 | 00 16 00 01 00 00 00 00 |IDENTd..|........|
|000032b0| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|000032c0| 00 01 00 00 00 a2 06 50 | 03 44 06 98 03 dc 00 01 |.......P|.D......|
|000032d0| 00 00 00 00 00 15 00 00 | 00 0c 00 00 00 03 00 03 |........|........|
|000032e0| 00 01 00 01 00 04 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|000032f0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00003300| 00 03 00 00 ff ff ff ff | ff ff ff ff 00 54 00 68 |........|.....T.h|
|00003310| 00 34 00 30 00 00 01 3c | 00 1d 00 01 00 00 00 00 |.4.0...<|........|
|00003320| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 06 50 |........|.......P|
|00003330| 03 74 06 99 03 dd 01 00 | 81 81 00 14 00 09 00 00 |.t......|........|
|00003340| 00 00 00 01 00 03 00 01 | 00 03 59 45 53 00 00 00 |........|..YES...|
|00003350| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00003360| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 a0 06 4c |........|.......L|
|00003370| 03 f0 06 98 04 e0 00 01 | 00 00 00 00 00 15 00 00 |........|........|
|00003380| 00 0c 00 00 00 03 00 03 | 00 01 00 01 00 04 00 00 |........|........|
|00003390| 00 00 00 00 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000033a0| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|000033b0| ff ff ff ff 00 54 00 c0 | 00 34 00 30 00 00 01 3d |.....T..|.4.0...=|
|000033c0| 00 1e 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000033d0| 00 00 00 00 00 02 06 4c | 04 20 06 99 04 e1 01 00 |.......L|. ......|
|000033e0| 81 81 00 14 00 09 00 00 | 00 00 00 01 00 03 00 01 |........|........|
|000033f0| 00 02 4e 4f 00 00 00 16 | 00 01 00 00 00 00 00 0b |..NO....|........|
|00003400| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 01 |........|........|
|00003410| 00 00 00 ae 0a e8 00 b0 | 0b 30 05 f8 00 01 00 00 |........|.0......|
|00003420| 00 00 00 15 00 00 00 0c | 00 00 00 03 00 02 00 2a |........|.......*|
|00003430| 00 01 00 02 00 00 00 00 | 00 04 00 01 00 00 00 00 |........|........|
|00003440| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 03 00 03 |........|........|
|00003450| 00 00 ff ff ff ff ff ff | ff ff 01 84 01 26 00 34 |........|.....&.4|
|00003460| 00 30 00 00 01 3e 00 2c | 00 01 00 00 00 00 00 00 |.0...>.,|........|
|00003470| 00 00 00 00 00 00 00 00 | 00 00 00 02 0a e8 00 b0 |........|........|
|00003480| 0b 31 02 34 01 01 81 80 | 00 14 00 0a 00 00 00 00 |.1.4....|........|
|00003490| 00 01 00 02 00 01 00 0f | 53 55 50 45 52 56 49 53 |........|SUPERVIS|
|000034a0| 4f 52 20 4e 41 4d 45 6d | 00 00 00 16 00 01 00 00 |OR NAMEm|........|
|000034b0| 00 00 00 0c 00 09 00 14 | 00 00 00 0a 00 00 00 00 |........|........|
|000034c0| 00 00 00 01 00 00 00 aa | 0a e8 06 38 0b 30 09 20 |........|...8.0. |
|000034d0| 00 01 00 00 00 00 00 15 | 00 00 00 0c 00 00 00 03 |........|........|
|000034e0| 00 02 00 01 00 01 00 02 | 00 00 00 00 00 04 00 01 |........|........|
|000034f0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00003500| 00 03 00 03 00 00 ff ff | ff ff ff ff ff ff 01 24 |........|.......$|
|00003510| 01 26 00 34 00 24 00 00 | 01 3f 00 2d 00 01 00 00 |.&.4.$..|.?.-....|
|00003520| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 02 |........|........|
|00003530| 0a e8 06 38 0b 31 07 5c | 01 01 81 80 00 14 00 0a |...8.1.\|........|
|00003540| 00 00 00 00 00 01 00 02 | 00 01 00 0b 20 57 4f 52 |........|.... WOR|
|00003550| 4b 20 50 48 4f 4e 45 db | 00 00 00 16 00 01 00 00 |K PHONE.|........|
|00003560| 00 00 00 0c 00 09 00 14 | 00 00 00 0a 00 00 00 00 |........|........|
|00003570| 00 00 00 06 00 00 01 98 | 09 ec 00 70 0a e8 00 a8 |........|...p....|
|00003580| 00 01 00 00 09 ec 00 70 | 0a e8 00 a8 00 30 00 28 |.......p|.....0.(|
|00003590| 01 2c 00 60 00 00 00 00 | 01 66 00 00 00 00 00 00 |.,.`....|.f......|
|000035a0| 00 00 00 00 00 00 00 00 | 00 00 01 66 ff ff ff ff |........|...f....|
|000035b0| 00 3e 00 0d 11 01 a0 00 | 82 a1 00 96 00 0c 01 00 |.>......|........|
|000035c0| 01 0e 02 00 01 0e 00 00 | 00 00 a1 00 9a 00 08 ff |........|........|
|000035d0| fc 00 00 00 1d 00 00 03 | 00 14 04 01 0d 00 0a 28 |........|.......(|
|000035e0| 00 22 ff e9 08 43 4f 4d | 4d 45 4e 54 53 01 00 0a |."...COM|MENTS...|
|000035f0| 00 00 00 00 00 3d 00 0c | 90 00 04 00 00 00 00 00 |.....=..|........|
|00003600| 3d 00 20 00 00 00 00 00 | 3d 00 20 00 00 00 00 00 |=. .....|=. .....|
|00003610| 3d 00 20 00 01 00 00 00 | 00 1d 80 00 00 1f c0 00 |=. .....|........|
|00003620| 00 1b 40 00 00 16 c0 00 | 00 1f c0 00 00 0d c0 00 |..@.....|........|
|00003630| 00 18 00 00 00 18 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00003640| 00 18 40 00 00 18 00 00 | 00 1f c0 00 00 1f c0 00 |..@.....|........|
|00003650| 00 13 00 00 00 06 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|00003660| 00 10 40 00 00 00 00 00 | 00 18 c0 00 00 1a c0 00 |..@.....|........|
|00003670| 00 12 40 00 00 1f c0 00 | 00 1f c0 00 00 10 40 00 |..@.....|......@.|
|00003680| 00 10 40 00 00 1f c0 00 | 00 1f c0 00 00 1e 40 00 |..@.....|......@.|
|00003690| 00 07 80 00 00 07 80 00 | 00 1e 40 00 00 1f c0 00 |........|..@.....|
|000036a0| 00 1f c0 00 00 10 40 00 | 00 1f c0 00 00 1f c0 00 |......@.|........|
|000036b0| 00 1e 40 00 00 07 80 00 | 00 07 80 00 00 1e 40 00 |..@.....|......@.|
|000036c0| 00 1f c0 00 00 1f c0 00 | 00 10 40 00 00 00 00 00 |........|..@.....|
|000036d0| 00 07 00 00 00 0f 80 00 | 00 18 c0 00 00 10 40 00 |........|......@.|
|000036e0| 00 18 c0 00 00 0f 80 00 | 00 07 00 00 00 18 80 00 |........|........|
|000036f0| 00 18 c0 00 00 10 40 00 | 00 10 40 00 00 18 c0 00 |......@.|..@.....|
|00003700| 00 0f 80 00 00 07 00 00 | 00 a0 00 97 a0 00 83 ff |........|........|
|00003710| 00 07 00 00 00 a4 0a 58 | 00 e4 0a 83 06 30 00 01 |.......X|.....0..|
|00003720| 00 00 ff ff ff ff ff ff | ff ff 00 01 00 00 00 00 |........|........|
|00003730| 00 00 00 02 0a 58 00 e4 | 0a 83 06 30 00 00 00 00 |.....X..|...0....|
|00003740| 00 14 00 09 00 00 00 00 | 00 01 00 01 00 01 00 50 |........|.......P|
|00003750| 53 55 50 45 52 56 49 53 | 4f 52 20 2f 20 4d 41 4e |SUPERVIS|OR / MAN|
|00003760| 41 47 45 52 20 43 4f 4d | 4d 45 4e 54 53 20 28 72 |AGER COM|MENTS (r|
|00003770| 65 63 6f 72 64 20 61 6e | 79 20 6f 62 73 65 72 76 |ecord an|y observ|
|00003780| 61 74 69 6f 6e 73 20 72 | 65 6c 61 74 65 64 20 74 |ations r|elated t|
|00003790| 6f 20 74 68 69 73 20 69 | 6e 63 69 64 65 6e 74 29 |o this i|ncident)|
|000037a0| 00 00 00 16 00 01 00 00 | 00 00 00 0b 00 08 00 14 |........|........|
|000037b0| 00 00 00 09 00 00 00 00 | 00 00 00 01 00 00 00 a4 |........|........|
|000037c0| 0a 84 00 ec 0a c0 08 bc | 00 01 00 00 00 00 00 15 |........|........|
|000037d0| 00 00 00 0c 00 00 00 01 | 00 01 00 00 00 00 00 02 |........|........|
|000037e0| 00 00 00 00 00 04 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|000037f0| 00 00 00 00 00 00 00 00 | 00 03 00 03 00 00 ff ff |........|........|
|00003800| ff ff ff ff ff ff 01 f4 | 01 26 00 28 00 28 00 00 |........|.&.(.(..|
|00003810| 01 41 00 2b 00 01 00 00 | 00 00 00 00 00 00 00 00 |.A.+....|........|
|00003820| 00 00 00 00 00 00 00 02 | 0a c1 00 ec 0a c1 08 bd |........|........|
|00003830| 01 01 81 80 00 14 00 09 | 00 00 00 00 00 01 00 02 |........|........|
|00003840| 00 01 00 05 46 69 65 6c | 64 6d 00 00 00 16 00 01 |....Fiel|dm......|
|00003850| 00 00 00 00 00 0b 00 08 | 00 14 00 00 00 09 00 00 |........|........|
|00003860| 00 00 00 00 00 01 00 00 | 00 a4 02 30 00 f8 02 60 |........|...0...`|
|00003870| 01 30 00 01 00 00 00 00 | 00 15 00 00 00 0c 00 00 |.0......|........|
|00003880| 00 03 00 03 00 01 00 00 | 00 04 00 00 00 00 00 00 |........|........|
|00003890| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000038a0| 00 00 00 03 00 03 00 00 | ff ff ff ff ff ff ff ff |........|........|
|000038b0| 00 14 00 14 00 1c 00 1c | 00 00 01 43 00 0a 00 01 |........|...C....|
|000038c0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000038d0| 00 02 02 61 00 f8 02 61 | 01 31 01 00 81 81 00 14 |...a...a|.1......|
|000038e0| 00 09 00 00 00 00 00 03 | 00 03 00 02 00 05 46 69 |........|......Fi|
|000038f0| 65 6c 64 b6 00 00 00 16 | 00 01 00 00 00 00 00 0b |eld.....|........|
|00003900| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 01 |........|........|
|00003910| 00 00 00 a8 01 ac 03 fc | 01 fc 06 84 00 01 00 00 |........|........|
|00003920| 00 00 00 15 00 00 00 0c | 00 00 00 03 00 02 00 00 |........|........|
|00003930| 00 01 00 02 00 00 00 00 | 00 04 00 01 00 00 00 00 |........|........|
|00003940| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|00003950| 00 00 ff ff ff ff ff ff | ff ff 00 e0 00 b4 00 34 |........|.......4|
|00003960| 00 30 00 00 01 44 00 08 | 00 01 00 00 00 00 00 00 |.0...D..|........|
|00003970| 00 00 00 00 00 00 00 00 | 00 00 00 02 01 ac 03 fc |........|........|
|00003980| 01 fd 04 dc 01 01 81 80 | 00 14 00 09 00 00 00 00 |........|........|
|00003990| 00 01 00 02 00 01 00 0a | 44 45 50 54 2e 20 4e 41 |........|DEPT. NA|
|000039a0| 4d 45 00 00 00 16 00 01 | 00 00 00 00 00 0b 00 08 |ME......|........|
|000039b0| 00 14 00 00 00 09 00 00 | 00 00 00 00 00 0d 00 00 |........|........|
|000039c0| 01 0e 00 d4 04 58 01 08 | 06 44 00 00 00 00 00 00 |.....X..|.D......|
|000039d0| 00 00 00 00 00 02 00 06 | 00 00 00 82 00 d8 04 58 |........|.......X|
|000039e0| 00 fc 04 7c 00 01 00 00 | 00 d8 04 58 00 fc 04 7c |...|....|...X...||
|000039f0| 00 30 00 28 00 54 00 4c | 00 00 00 00 00 50 00 00 |.0.(.T.L|.....P..|
|00003a00| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 50 |........|.......P|
|00003a10| 00 fb 01 a5 01 04 01 ae | 11 01 a0 30 39 a0 00 82 |........|...09...|
|00003a20| 01 00 0a 00 00 00 00 02 | d0 02 40 90 00 02 00 fb |........|..@.....|
|00003a30| 01 a4 01 04 01 b4 00 fb | 01 a5 01 04 01 ae 00 fb |........|........|
|00003a40| 01 a5 01 04 01 ae 00 00 | 31 80 4a 40 4a 40 3f 80 |........|1.J@J@?.|
|00003a50| 0a 00 3f 80 4a 40 4a 40 | 31 80 a0 00 83 ff 00 07 |..?.J@J@|1.......|
|00003a60| 00 00 00 6c 00 d4 04 84 | 01 08 06 44 00 01 00 00 |...l....|...D....|
|00003a70| ff ff ff ff ff ff ff ff | 00 01 00 00 00 00 00 00 |........|........|
|00003a80| 00 02 00 d4 04 84 01 08 | 06 44 00 00 00 00 00 14 |........|.D......|
|00003a90| 00 0a 00 00 00 00 00 01 | 00 01 00 01 00 18 2d 20 |........|......- |
|00003aa0| 55 20 66 6f 72 20 41 75 | 78 69 6c 69 61 72 79 20 |U for Au|xiliary |
|00003ab0| 57 69 6e 64 6f 77 00 00 | 00 16 00 01 00 00 00 00 |Window..|........|
|00003ac0| 00 0c 00 09 00 14 00 00 | 00 0a 00 00 00 00 00 00 |........|........|
|00003ad0| 00 03 00 00 00 34 00 d0 | 04 48 01 04 06 44 00 01 |.....4..|.H...D..|
|00003ae0| 00 00 00 03 00 00 ff ff | ff ff ff ff ff ff 00 01 |........|........|
|00003af0| 00 00 00 00 00 00 00 00 | 00 01 00 00 00 00 00 00 |........|........|
|00003b00| 00 00 00 00 00 00 00 00 | 00 00 00 07 00 00 00 80 |........|........|
|00003b10| 0a 00 00 e4 0a 2c 04 6c | 00 01 00 00 ff ff ff ff |.....,.l|........|
|00003b20| ff ff ff ff 00 01 00 00 | 00 00 00 00 00 02 0a 00 |........|........|
|00003b30| 00 e4 0a 2c 04 6c 00 00 | 00 00 00 14 00 09 00 00 |...,.l..|........|
|00003b40| 00 00 00 01 00 01 00 01 | 00 2c 20 45 4d 50 4c 4f |........|., EMPLO|
|00003b50| 59 45 45 20 43 4c 41 49 | 4d 20 46 4f 52 4d 20 28 |YEE CLAI|M FORM (|
|00003b60| 44 57 43 20 46 4f 52 4d | 20 31 29 20 50 52 4f 56 |DWC FORM| 1) PROV|
|00003b70| 49 44 45 44 20 0d 00 00 | 00 16 00 01 00 00 00 00 |IDED ...|........|
|00003b80| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|00003b90| 00 01 00 00 00 a2 0a 04 | 04 8c 0a 50 05 10 00 01 |........|...P....|
|00003ba0| 00 00 00 00 00 15 00 00 | 00 0c 00 00 00 03 00 03 |........|........|
|00003bb0| 00 01 00 01 00 04 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|00003bc0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 01 |........|........|
|00003bd0| 00 03 00 00 ff ff ff ff | ff ff ff ff 00 54 00 58 |........|.....T.X|
|00003be0| 00 34 00 30 00 00 01 45 | 00 28 00 01 00 00 00 00 |.4.0...E|.(......|
|00003bf0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 0a 04 |........|........|
|00003c00| 04 b8 0a 51 05 11 01 00 | 81 81 00 14 00 09 00 00 |...Q....|........|
|00003c10| 00 00 00 01 00 03 00 01 | 00 03 59 45 53 00 00 00 |........|..YES...|
|00003c20| 00 16 00 01 00 00 00 00 | 00 0b 00 08 00 14 00 00 |........|........|
|00003c30| 00 09 00 00 00 00 00 00 | 00 01 00 00 00 a0 0a 08 |........|........|
|00003c40| 05 64 0a 54 06 54 00 01 | 00 00 00 00 00 15 00 00 |.d.T.T..|........|
|00003c50| 00 0c 00 00 00 03 00 03 | 00 01 00 01 00 04 00 00 |........|........|
|00003c60| 00 00 00 00 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00003c70| 00 00 00 00 00 00 00 01 | 00 03 00 00 ff ff ff ff |........|........|
|00003c80| ff ff ff ff 00 54 00 c0 | 00 34 00 30 00 00 01 46 |.....T..|.4.0...F|
|00003c90| 00 29 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |.)......|........|
|00003ca0| 00 00 00 00 00 02 0a 08 | 05 94 0a 55 06 55 01 00 |........|...U.U..|
|00003cb0| 81 81 00 14 00 09 00 00 | 00 00 00 01 00 03 00 01 |........|........|
|00003cc0| 00 02 4e 4f 00 00 00 16 | 00 01 00 00 00 00 00 0b |..NO....|........|
|00003cd0| 00 08 00 14 00 00 00 09 | 00 00 00 00 00 00 00 01 |........|........|
|00003ce0| 00 00 00 ac 0a 00 06 1c | 0a 48 08 d8 00 01 00 00 |........|.H......|
|00003cf0| 00 00 00 15 00 00 00 0c | 00 00 00 03 00 02 00 00 |........|........|
|00003d00| 00 01 00 02 00 00 00 00 | 00 04 00 01 00 00 00 00 |........|........|
|00003d10| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 03 00 03 |........|........|
|00003d20| 00 00 ff ff ff ff ff ff | ff ff 01 34 01 26 00 34 |........|...4.&.4|
|00003d30| 00 30 00 00 01 47 00 2a | 00 01 00 00 00 00 00 00 |.0...G.*|........|
|00003d40| 00 00 00 00 00 00 00 00 | 00 00 00 02 0a 00 06 1c |........|........|
|00003d50| 0a 49 07 50 01 01 81 80 | 00 14 00 09 00 00 00 00 |.I.P....|........|
|00003d60| 00 01 00 02 00 01 00 0d | 44 41 54 45 20 50 52 4f |........|DATE PRO|
|00003d70| 56 49 44 45 44 db 00 00 | 00 16 00 01 00 00 00 00 |VIDED...|........|
|00003d80| 00 0b 00 08 00 14 00 00 | 00 09 00 00 00 00 00 00 |........|........|
|00003d90| 00 07 00 00 00 76 0a 2c | 00 e4 0a 5b 03 44 00 01 |.....v.,|...[.D..|
|00003da0| 00 00 ff ff ff ff ff ff | ff ff 00 01 00 00 00 00 |........|........|
|00003db0| 00 00 00 02 0a 2c 00 e4 | 0a 5b 03 44 00 00 00 00 |.....,..|.[.D....|
|00003dc0| 00 14 00 09 00 00 00 00 | 00 01 00 01 00 01 00 21 |........|.......!|
|00003dd0| 54 4f 20 54 48 45 20 45 | 4d 50 4c 4f 59 45 45 20 |TO THE E|MPLOYEE |
|00003de0| 28 43 61 6c 69 66 6f 72 | 6e 69 61 20 4f 6e 6c 79 |(Califor|nia Only|
|00003df0| 29 00 00 00 00 16 00 01 | 00 00 00 00 00 0b 00 08 |).......|........|
|00003e00| 00 14 00 00 00 09 00 00 | 00 00 00 00 00 07 00 00 |........|........|
|00003e10| 00 f0 0b 9c 00 59 0b dc | 09 37 00 01 00 00 ff ff |.....Y..|.7......|
|00003e20| ff ff ff ff ff ff 00 01 | 00 00 00 00 00 00 00 02 |........|........|
|00003e30| 0b 9c 00 59 0b dc 09 37 | 00 00 00 00 00 14 00 0c |...Y...7|........|
|00003e40| ff 00 00 00 00 01 00 01 | 00 01 00 73 50 6c 65 61 |........|...sPlea|
|00003e50| 73 65 20 62 65 20 73 75 | 72 65 20 74 6f 20 73 65 |se be su|re to se|
|00003e60| 6c 65 63 74 20 22 50 72 | 69 6e 74 20 77 69 74 68 |lect "Pr|int with|
|00003e70| 20 50 61 72 74 20 4c 61 | 62 65 6c 73 22 20 77 68 | Part La|bels" wh|
|00003e80| 65 6e 20 70 72 69 6e 74 | 69 6e 67 20 2d 20 46 6f |en print|ing - Fo|
|00003e90| 6c 64 20 61 6e 64 20 6d | 61 69 6c 20 65 61 63 68 |ld and m|ail each|
|00003ea0| 20 63 6f 70 79 20 74 6f | 20 61 70 70 72 6f 70 72 | copy to| appropr|
|00003eb0| 69 61 74 65 20 64 65 70 | 61 72 74 6d 65 6e 74 00 |iate dep|artment.|
|00003ec0| 00 00 00 3e 00 03 00 00 | 00 00 00 0c 00 09 00 14 |...>....|........|
|00003ed0| 00 00 00 0c 00 00 00 00 | 00 00 00 00 00 1a 00 0c |........|........|
|00003ee0| 00 09 00 14 01 00 00 0c | 00 00 00 00 00 00 00 00 |........|........|
|00003ef0| 00 30 00 0c 00 09 00 14 | 00 00 00 0c 00 00 00 00 |.0......|........|
|00003f00| 00 00 00 00 00 00 00 03 | 00 00 00 34 00 10 00 10 |........|...4....|
|00003f10| 0c 50 09 80 00 01 00 00 | 00 03 00 01 ff ff ff ff |.P......|........|
|00003f20| ff ff ff ff 00 00 00 00 | 00 00 00 00 00 00 00 01 |........|........|
|00003f30| 00 28 00 28 00 28 00 28 | 00 00 00 00 00 00 00 00 |.(.(.(.(|........|
|00003f40| 00 07 00 00 17 1c 00 60 | 00 18 0c 30 04 ac 00 01 |.......`|...0....|
|00003f50| 00 00 ff ff ff ff ff ff | ff ff 00 01 00 00 00 00 |........|........|
|00003f60| 00 00 00 02 00 60 00 18 | 0c 30 04 ac 00 00 00 00 |.....`..|.0......|
|00003f70| 00 14 00 0a 00 01 00 00 | 00 01 00 01 00 60 13 a7 |........|.....`..|
|00003f80| 48 6f 77 20 74 6f 20 68 | 65 6c 70 20 79 6f 75 72 |How to h|elp your|
|00003f90| 20 65 6d 70 6c 6f 79 65 | 65 20 66 69 6c 65 20 61 | employe|e file a|
|00003fa0| 20 63 6c 61 69 6d d1 61 | 20 73 74 65 70 2d 62 79 | claim.a| step-by|
|00003fb0| 2d 73 74 65 70 20 67 75 | 69 64 65 20 66 6f 72 20 |-step gu|ide for |
|00003fc0| 73 75 70 65 72 76 69 73 | 6f 72 73 2e 20 20 4e 6f |supervis|ors.  No|
|00003fd0| 74 65 3a 20 20 49 66 20 | 79 6f 75 20 61 72 65 20 |te:  If |you are |
|00003fe0| 61 74 20 74 68 65 20 46 | 72 65 6d 6f 6e 74 20 4d |at the F|remont M|
|00003ff0| 61 6e 75 66 61 63 74 75 | 72 69 6e 67 20 53 69 74 |anufactu|ring Sit|
|00004000| 65 2c 20 73 65 6e 64 20 | 61 6c 6c 20 66 6f 72 6d |e, send |all form|
|00004010| 73 20 61 6e 64 20 72 65 | 70 6f 72 74 73 20 74 6f |s and re|ports to|
|00004020| 20 74 68 65 20 53 69 74 | 65 20 4e 75 72 73 65 2e | the Sit|e Nurse.|
|00004030| 20 20 54 68 65 20 53 69 | 74 65 20 4e 75 72 73 65 |  The Si|te Nurse|
|00004040| 20 77 69 6c 6c 20 62 65 | 20 79 6f 75 72 20 70 72 | will be| your pr|
|00004050| 69 6d 61 72 79 20 63 6f | 6e 74 61 63 74 20 66 6f |imary co|ntact fo|
|00004060| 72 20 57 6f 72 6b 65 72 | 73 20 43 6f 6d 70 65 6e |r Worker|s Compen|
|00004070| 73 61 74 69 6f 6e 20 43 | 6c 61 69 6d 73 2e 20 0d |sation C|laims. .|
|00004080| 0d 31 2e 20 09 46 69 6c | 6c 20 6f 75 74 20 74 68 |.1. .Fil|l out th|
|00004090| 65 20 22 53 75 70 65 72 | 76 69 73 6f 72 20 57 6f |e "Super|visor Wo|
|000040a0| 72 6b 20 49 6e 6a 75 72 | 79 20 49 6c 6c 6e 65 73 |rk Injur|y Illnes|
|000040b0| 73 20 52 65 70 6f 72 74 | 22 20 66 6f 72 6d 20 61 |s Report|" form a|
|000040c0| 73 20 73 6f 6f 6e 20 61 | 73 20 79 6f 75 72 20 65 |s soon a|s your e|
|000040d0| 6d 70 6c 6f 79 65 65 20 | 74 65 6c 6c 73 20 79 6f |mployee |tells yo|
|000040e0| 75 20 77 68 61 74 20 68 | 61 73 20 68 61 70 70 65 |u what h|as happe|
|000040f0| 6e 65 64 2e 09 59 6f 75 | 20 63 61 6e 20 6f 62 74 |ned..You| can obt|
|00004100| 61 69 6e 20 61 6c 6c 20 | 66 6f 72 6d 73 20 74 68 |ain all |forms th|
|00004110| 72 6f 75 67 68 20 48 75 | 6d 61 6e 20 52 65 73 6f |rough Hu|man Reso|
|00004120| 75 72 63 65 73 2c 20 52 | 69 73 6b 20 4d 61 6e 61 |urces, R|isk Mana|
|00004130| 67 65 6d 65 6e 74 2c 20 | 45 6e 76 69 72 6f 6e 6d |gement, |Environm|
|00004140| 65 6e 74 61 6c 20 48 65 | 61 6c 74 68 20 61 6e 64 |ental He|alth and|
|00004150| 20 53 61 66 65 74 79 2c | 20 6f 72 20 69 6e 20 74 | Safety,| or in t|
|00004160| 68 65 20 57 6f 72 6b 65 | 72 73 d5 20 43 6f 6d 70 |he Worke|rs. Comp|
|00004170| 65 6e 73 61 74 69 6f 6e | 20 66 6f 6c 64 65 72 20 |ensation| folder |
|00004180| 75 6e 64 65 72 20 74 68 | 65 20 42 65 6e 65 66 69 |under th|e Benefi|
|00004190| 74 73 20 69 63 6f 6e 20 | 6f 6e 20 41 70 70 6c 65 |ts icon |on Apple|
|000041a0| 4c 69 6e 6b 2e 20 20 41 | 66 74 65 72 20 79 6f 75 |Link.  A|fter you|
|000041b0| d5 76 65 20 63 6f 6d 70 | 6c 65 74 65 64 20 61 6e |.ve comp|leted an|
|000041c0| 64 20 73 69 67 6e 65 64 | 20 74 68 65 20 66 6f 72 |d signed| the for|
|000041d0| 6d 2d 2d 61 6e 64 20 73 | 61 76 65 64 20 61 20 63 |m--and s|aved a c|
|000041e0| 6f 70 79 20 66 6f 72 20 | 79 6f 75 72 73 65 6c 66 |opy for |yourself|
|000041f0| 2d 2d 73 65 6e 64 20 61 | 20 63 6f 70 79 20 74 6f |--send a| copy to|
|00004200| 3a 0d 09 09 52 69 73 6b | 20 4d 61 6e 61 67 65 6d |:...Risk| Managem|
|00004210| 65 6e 74 20 44 65 70 74 | 2e 0d 09 09 41 74 74 65 |ent Dept|....Atte|
|00004220| 6e 74 69 6f 6e 3a 20 20 | 43 6c 61 69 6d 73 20 41 |ntion:  |Claims A|
|00004230| 64 6d 69 6e 69 73 74 72 | 61 74 69 6f 6e 20 4d 53 |dministr|ation MS|
|00004240| 20 32 38 2d 47 0d 0d 09 | 49 66 20 61 20 54 45 4d | 28-G...|If a TEM|
|00004250| 50 4f 52 41 52 59 20 45 | 4d 50 4c 4f 59 45 45 20 |PORARY E|MPLOYEE |
|00004260| 69 73 20 69 6e 6a 75 72 | 65 64 20 6f 6e 20 74 68 |is injur|ed on th|
|00004270| 65 20 6a 6f 62 2c 20 72 | 65 66 65 72 20 68 69 6d |e job, r|efer him|
|00004280| 20 6f 72 20 68 65 72 20 | 74 6f 20 74 68 65 20 74 | or her |to the t|
|00004290| 65 6d 70 6f 72 61 72 79 | 20 61 67 65 6e 63 79 d5 |emporary| agency.|
|000042a0| 73 20 57 6f 72 6b 65 72 | 73 d5 20 43 6f 6d 70 65 |s Worker|s. Compe|
|000042b0| 6e 73 61 74 69 6f 6e 20 | 70 72 6f 67 72 61 6d 2e |nsation |program.|
|000042c0| 20 20 48 6f 77 65 76 65 | 72 2c 20 73 69 6e 63 65 |  Howeve|r, since|
|000042d0| 20 4f 63 63 75 70 61 74 | 69 6f 6e 61 6c 20 48 65 | Occupat|ional He|
|000042e0| 61 6c 74 68 20 61 6e 64 | 20 53 61 66 65 74 79 20 |alth and| Safety |
|000042f0| 41 67 65 6e 63 79 20 28 | 4f 53 48 41 29 20 72 65 |Agency (|OSHA) re|
|00004300| 71 75 69 72 65 73 20 74 | 68 61 74 20 41 70 70 6c |quires t|hat Appl|
|00004310| 65 20 6b 65 65 70 20 61 | 20 72 65 63 6f 72 64 20 |e keep a| record |
|00004320| 6f 66 20 61 6c 6c 20 77 | 6f 72 6b 2d 72 65 6c 61 |of all w|ork-rela|
|00004330| 74 65 64 20 61 63 63 69 | 64 65 6e 74 73 2c 20 66 |ted acci|dents, f|
|00004340| 69 6c 6c 20 6f 75 74 20 | 74 68 65 20 53 75 70 65 |ill out |the Supe|
|00004350| 72 76 69 73 6f 72 20 20 | 57 6f 72 6b 20 49 6e 6a |rvisor  |Work Inj|
|00004360| 75 72 79 2f 49 6c 6c 6e | 65 73 73 20 52 65 70 6f |ury/Illn|ess Repo|
|00004370| 72 74 2e 20 20 53 65 6e | 64 20 74 68 65 73 65 20 |rt.  Sen|d these |
|00004380| 66 6f 72 6d 73 20 74 6f | 20 52 69 73 6b 20 4d 61 |forms to| Risk Ma|
|00004390| 6e 61 67 65 6d 65 6e 74 | 20 61 73 20 73 6f 6f 6e |nagement| as soon|
|000043a0| 20 61 73 20 70 6f 73 73 | 69 62 6c 65 2e 0d 09 20 | as poss|ible... |
|000043b0| 4e 6f 74 65 3a 20 53 6f | 6d 65 20 73 74 61 74 65 |Note: So|me state|
|000043c0| 73 2c 20 73 75 63 68 20 | 61 73 20 43 61 6c 69 66 |s, such |as Calif|
|000043d0| 6f 72 6e 69 61 2c 20 72 | 65 71 75 69 72 65 20 74 |ornia, r|equire t|
|000043e0| 68 61 74 20 74 68 65 20 | 65 6d 70 6c 6f 79 65 65 |hat the |employee|
|000043f0| 20 63 6f 6d 70 6c 65 74 | 65 20 73 65 70 61 72 61 | complet|e separa|
|00004400| 74 65 20 66 6f 72 6d 73 | 20 77 69 74 68 69 6e 20 |te forms| within |
|00004410| 32 34 20 68 6f 75 72 73 | 20 6f 66 20 74 68 65 20 |24 hours| of the |
|00004420| 69 6e 6a 75 72 79 2e 20 | 20 54 68 6f 73 65 20 66 |injury. | Those f|
|00004430| 6f 72 6d 73 20 61 72 65 | 20 61 76 61 69 6c 61 62 |orms are| availab|
|00004440| 6c 65 20 66 72 6f 6d 20 | 48 75 6d 61 6e 20 52 65 |le from |Human Re|
|00004450| 73 6f 75 72 63 65 73 2c | 20 52 69 73 6b 20 4d 61 |sources,| Risk Ma|
|00004460| 6e 61 67 65 6d 65 6e 74 | 20 6f 72 20 45 6e 76 69 |nagement| or Envi|
|00004470| 72 6f 6e 6d 65 6e 74 61 | 6c 20 48 65 61 6c 74 68 |ronmenta|l Health|
|00004480| 20 61 6e 64 20 53 61 66 | 65 74 79 20 28 45 48 26 | and Saf|ety (EH&|
|00004490| 53 29 2e 0d 09 20 20 55 | 2e 53 2e 20 41 70 70 6c |S)...  U|.S. Appl|
|000044a0| 65 20 65 6d 70 6c 6f 79 | 65 65 73 20 77 68 6f 20 |e employ|ees who |
|000044b0| 61 72 65 20 69 6e 6a 75 | 72 65 64 20 77 68 69 6c |are inju|red whil|
|000044c0| 65 20 74 72 61 76 65 6c | 69 6e 67 20 6f 6e 20 41 |e travel|ing on A|
|000044d0| 70 70 6c 65 20 62 75 73 | 69 6e 65 73 73 20 28 64 |pple bus|iness (d|
|000044e0| 6f 6d 65 73 74 69 63 61 | 6c 6c 79 20 6f 72 20 69 |omestica|lly or i|
|000044f0| 6e 74 65 72 6e 61 74 69 | 6f 6e 61 6c 6c 79 29 20 |nternati|onally) |
|00004500| 61 72 65 20 67 65 6e 65 | 72 61 6c 6c 79 20 63 6f |are gene|rally co|
|00004510| 76 65 72 65 64 20 62 79 | 20 57 6f 72 6b 65 72 73 |vered by| Workers|
|00004520| d5 20 43 6f 6d 70 65 6e | 73 61 74 69 6f 6e 20 73 |. Compen|sation s|
|00004530| 6f 20 79 6f 75 20 63 61 | 6e 20 66 6f 6c 6c 6f 77 |o you ca|n follow|
|00004540| 20 73 74 61 6e 64 61 72 | 64 20 70 72 6f 63 65 64 | standar|d proced|
|00004550| 75 72 65 73 2e 0d 09 4e | 6f 74 65 3a 20 20 49 66 |ures...N|ote:  If|
|00004560| 20 61 6e 20 61 63 63 69 | 64 65 6e 74 20 69 73 20 | an acci|dent is |
|00004570| 73 65 72 69 6f 75 73 20 | 61 6e 64 20 72 65 71 75 |serious |and requ|
|00004580| 69 72 65 73 20 65 6d 65 | 72 67 65 6e 63 79 20 6d |ires eme|rgency m|
|00004590| 65 64 69 63 61 6c 20 61 | 74 74 65 6e 74 69 6f 6e |edical a|ttention|
|000045a0| 20 6f 62 74 61 69 6e 20 | 74 68 65 20 6d 65 64 69 | obtain |the medi|
|000045b0| 63 61 6c 20 61 74 74 65 | 6e 74 69 6f 6e 20 6e 65 |cal atte|ntion ne|
|000045c0| 63 65 73 73 61 72 79 20 | 61 6e 64 20 74 68 65 6e |cessary |and then|
|000045d0| 20 6c 69 6e 6b 20 6f 72 | 20 70 68 6f 6e 65 20 52 | link or| phone R|
|000045e0| 69 73 6b 20 4d 61 6e 61 | 67 65 6d 65 6e 74 20 61 |isk Mana|gement a|
|000045f0| 6e 64 20 45 6e 76 69 72 | 6f 6e 6d 65 6e 74 61 6c |nd Envir|onmental|
|00004600| 20 48 65 61 6c 74 68 20 | 26 20 53 61 66 65 74 79 | Health |& Safety|
|00004610| 20 69 6d 6d 65 64 69 61 | 74 65 6c 79 20 74 68 65 | immedia|tely the|
|00004620| 6e 20 63 6f 6d 70 6c 65 | 74 65 20 74 68 65 20 53 |n comple|te the S|
|00004630| 75 70 65 72 76 69 73 6f | 72 20 52 65 70 6f 72 74 |uperviso|r Report|
|00004640| 20 66 6f 72 6d 2e 0d 0d | 32 2e 09 20 43 61 6c 6c | form...|2.. Call|
|00004650| 20 79 6f 75 72 20 48 75 | 6d 61 6e 20 52 65 73 6f | your Hu|man Reso|
|00004660| 75 72 63 65 73 20 6c 69 | 61 69 73 6f 6e 20 74 6f |urces li|aison to|
|00004670| 20 72 65 70 6f 72 74 20 | 74 68 65 20 69 6e 63 69 | report |the inci|
|00004680| 64 65 6e 74 2e 0d 0d 33 | 2e 09 20 53 65 74 20 61 |dent...3|.. Set a|
|00004690| 73 69 64 65 20 73 6f 6d | 65 20 74 69 6d 65 20 74 |side som|e time t|
|000046a0| 6f 20 69 6e 76 65 73 74 | 69 67 61 74 65 20 77 68 |o invest|igate wh|
|000046b0| 79 20 20 74 68 65 20 61 | 63 63 69 64 65 6e 74 20 |y  the a|ccident |
|000046c0| 6f 63 63 75 72 72 65 64 | 20 73 6f 20 74 68 61 74 |occurred| so that|
|000046d0| 20 73 74 65 70 73 20 63 | 61 6e 20 62 65 20 74 61 | steps c|an be ta|
|000046e0| 6b 65 6e 20 74 6f 20 70 | 72 65 76 65 6e 74 20 73 |ken to p|revent s|
|000046f0| 69 6d 69 6c 61 72 20 61 | 63 63 69 64 65 6e 74 73 |imilar a|ccidents|
|00004700| 20 69 6e 20 74 68 65 20 | 66 75 74 75 72 65 2e 20 | in the |future. |
|00004710| 20 49 66 20 79 6f 75 20 | 6e 65 65 64 20 61 73 73 | If you |need ass|
|00004720| 69 73 74 61 6e 63 65 20 | 69 6e 20 64 6f 69 6e 67 |istance |in doing|
|00004730| 20 74 68 69 73 2c 20 63 | 6f 6e 74 61 63 74 20 43 | this, c|ontact C|
|00004740| 6f 72 70 6f 72 61 74 65 | 20 6f 72 20 79 6f 75 72 |orporate| or your|
|00004750| 20 6f 6e 2d 73 69 74 65 | 20 45 6e 76 69 72 6f 6e | on-site| Environ|
|00004760| 6d 65 6e 74 61 6c 20 48 | 65 61 6c 74 68 20 26 20 |mental H|ealth & |
|00004770| 53 61 66 65 74 79 20 44 | 65 70 61 72 74 6d 65 6e |Safety D|epartmen|
|00004780| 74 20 74 6f 20 69 6d 70 | 6c 65 6d 65 6e 74 20 6e |t to imp|lement n|
|00004790| 65 63 65 73 73 61 72 79 | 20 63 68 61 6e 67 65 73 |ecessary| changes|
|000047a0| 20 74 6f 20 74 68 65 20 | 6a 6f 62 20 64 65 73 63 | to the |job desc|
|000047b0| 72 69 70 74 69 6f 6e 2e | 0d 0d 34 2e 09 20 53 74 |ription.|..4.. St|
|000047c0| 61 79 20 61 77 61 72 65 | 20 6f 66 20 74 68 65 20 |ay aware| of the |
|000047d0| 69 6e 6a 75 72 65 64 20 | 65 6d 70 6c 6f 79 65 65 |injured |employee|
|000047e0| d5 73 20 77 6f 72 6b 20 | 73 74 61 74 75 73 2e 20 |.s work |status. |
|000047f0| 20 54 68 69 73 20 72 65 | 71 75 69 72 65 73 20 67 | This re|quires g|
|00004800| 65 74 74 69 6e 67 20 63 | 6f 70 69 65 73 20 6f 66 |etting c|opies of|
|00004810| 20 74 68 65 20 44 6f 63 | 74 6f 72 d5 73 20 46 69 | the Doc|tor.s Fi|
|00004820| 72 73 74 20 52 65 70 6f | 72 74 20 6f 72 20 61 6e |rst Repo|rt or an|
|00004830| 79 20 77 6f 72 6b 20 73 | 74 61 74 75 73 20 72 65 |y work s|tatus re|
|00004840| 70 6f 72 74 73 20 61 6e | 64 20 72 65 76 69 65 77 |ports an|d review|
|00004850| 69 6e 67 20 77 69 74 68 | 20 74 68 65 20 65 6d 70 |ing with| the emp|
|00004860| 6c 6f 79 65 65 20 61 6e | 79 20 72 65 73 74 72 69 |loyee an|y restri|
|00004870| 63 74 69 6f 6e 73 20 63 | 6f 6e 63 65 72 6e 69 6e |ctions c|oncernin|
|00004880| 67 20 77 6f 72 6b 2e 20 | 20 49 66 20 79 6f 75 20 |g work. | If you |
|00004890| 61 6e 74 69 63 69 70 61 | 74 65 20 74 68 65 72 65 |anticipa|te there|
|000048a0| 20 77 69 6c 6c 20 62 65 | 20 6c 6f 73 74 20 74 69 | will be| lost ti|
|000048b0| 6d 65 20 6c 65 74 20 48 | 75 6d 61 6e 20 52 65 73 |me let H|uman Res|
|000048c0| 6f 75 72 63 65 73 20 61 | 6e 64 20 52 69 73 6b 20 |ources a|nd Risk |
|000048d0| 4d 61 6e 61 67 65 6d 65 | 6e 74 20 6b 6e 6f 77 20 |Manageme|nt know |
|000048e0| 69 6d 6d 65 64 69 61 74 | 65 6c 79 2e 0d 0d 35 2e |immediat|ely...5.|
|000048f0| 09 54 68 65 20 69 6e 6a | 75 72 65 64 20 65 6d 70 |.The inj|ured emp|
|00004900| 6c 6f 79 65 65 20 6d 75 | 73 74 20 73 68 6f 77 20 |loyee mu|st show |
|00004910| 79 6f 75 20 61 20 44 6f | 63 74 6f 72 73 20 52 65 |you a Do|ctors Re|
|00004920| 6c 65 61 73 65 20 62 65 | 66 6f 72 65 20 68 65 20 |lease be|fore he |
|00004930| 6f 72 20 73 68 65 20 72 | 65 74 75 72 6e 73 20 74 |or she r|eturns t|
|00004940| 6f 20 77 6f 72 6b 2e 20 | 20 0d 20 20 49 66 20 74 |o work. | .  If t|
|00004950| 68 65 20 65 6d 70 6c 6f | 79 65 65 20 72 65 74 75 |he emplo|yee retu|
|00004960| 72 6e 73 20 74 6f 20 77 | 6f 72 6b 20 77 69 74 68 |rns to w|ork with|
|00004970| 20 6e 6f 20 72 65 73 74 | 72 69 63 74 69 6f 6e 73 | no rest|rictions|
|00004980| 20 20 79 6f 75 20 73 68 | 6f 75 6c 64 20 66 6f 6c |  you sh|ould fol|
|00004990| 6c 6f 77 20 75 70 20 69 | 6e 66 6f 72 6d 61 6c 6c |low up i|nformall|
|000049a0| 79 20 77 69 74 68 20 74 | 68 65 20 65 6d 70 6c 6f |y with t|he emplo|
|000049b0| 79 65 65 20 61 66 74 65 | 72 20 61 20 66 65 77 20 |yee afte|r a few |
|000049c0| 64 61 79 73 d1 6a 75 73 | 74 20 74 6f 20 63 68 65 |days.jus|t to che|
|000049d0| 63 6b 20 6f 6e 20 68 6f | 77 20 74 68 69 6e 67 73 |ck on ho|w things|
|000049e0| 20 61 72 65 20 67 6f 69 | 6e 67 2e 0d 20 20 49 66 | are goi|ng..  If|
|000049f0| 20 74 68 65 20 64 6f 63 | 74 6f 72 20 72 65 6c 65 | the doc|tor rele|
|00004a00| 61 73 65 73 20 74 68 65 | 20 65 6d 70 6c 6f 79 65 |ases the| employe|
|00004a10| 65 20 74 6f 20 72 65 74 | 75 72 6e 20 74 6f 20 77 |e to ret|urn to w|
|00004a20| 6f 72 6b 20 77 69 74 68 | 20 6d 6f 64 69 66 69 65 |ork with| modifie|
|00004a30| 64 20 64 75 74 69 65 73 | 2c 20 79 6f 75 20 6e 65 |d duties|, you ne|
|00004a40| 65 64 20 74 6f 20 64 65 | 74 65 72 6d 69 6e 65 20 |ed to de|termine |
|00004a50| 77 68 65 74 68 65 72 20 | 6f 72 20 6e 6f 74 20 74 |whether |or not t|
|00004a60| 68 65 20 6a 6f 62 20 63 | 61 6e 20 62 65 20 6d 6f |he job c|an be mo|
|00004a70| 64 69 66 69 65 64 20 61 | 6e 64 20 73 74 69 6c 6c |dified a|nd still|
|00004a80| 20 6d 65 65 74 20 62 6f | 74 68 20 41 70 70 6c 65 | meet bo|th Apple|
|00004a90| d5 73 20 61 6e 64 20 74 | 68 65 20 65 6d 70 6c 6f |.s and t|he emplo|
|00004aa0| 79 65 65 d5 73 20 6e 65 | 65 64 73 2e 20 20 49 74 |yee.s ne|eds.  It|
|00004ab0| 20 6d 61 79 20 62 65 20 | 6e 65 63 65 73 73 61 72 | may be |necessar|
|00004ac0| 79 20 74 6f 20 67 65 74 | 20 72 65 2d 65 76 61 6c |y to get| re-eval|
|00004ad0| 75 61 74 69 6f 6e 73 20 | 66 72 6f 6d 20 74 68 65 |uations |from the|
|00004ae0| 20 64 6f 63 74 6f 72 20 | 62 65 66 6f 72 65 20 63 | doctor |before c|
|00004af0| 6f 6d 69 6e 67 20 75 70 | 6f 6e 20 74 68 65 20 72 |oming up|on the r|
|00004b00| 69 67 68 74 20 6d 6f 64 | 69 66 69 63 61 74 69 6f |ight mod|ificatio|
|00004b10| 6e 73 2e 20 20 53 65 65 | 6b 20 61 73 73 69 73 74 |ns.  See|k assist|
|00004b20| 61 6e 63 65 20 66 72 6f | 6d 20 45 6e 76 69 72 6f |ance fro|m Enviro|
|00004b30| 6e 6d 65 6e 74 61 6c 20 | 48 65 61 6c 74 68 20 26 |nmental |Health &|
|00004b40| 20 53 61 66 65 74 79 20 | 61 6e 64 20 75 70 64 61 | Safety |and upda|
|00004b50| 74 65 20 52 69 73 6b 20 | 4d 61 6e 61 67 65 6d 65 |te Risk |Manageme|
|00004b60| 6e 74 20 61 6e 64 20 48 | 75 6d 61 6e 20 52 65 73 |nt and H|uman Res|
|00004b70| 6f 75 72 63 65 73 20 6f | 6e 20 61 6c 6c 20 74 68 |ources o|n all th|
|00004b80| 65 73 65 20 61 63 74 69 | 76 69 74 69 65 73 2e 0d |ese acti|vities..|
|00004b90| 0d 09 49 66 20 6a 6f 62 | 20 6d 6f 64 69 66 69 63 |..If job| modific|
|00004ba0| 61 74 69 6f 6e 20 69 73 | 20 4e 4f 54 20 70 6f 73 |ation is| NOT pos|
|00004bb0| 73 69 62 6c 65 2c 20 74 | 61 6c 6b 20 77 69 74 68 |sible, t|alk with|
|00004bc0| 20 48 75 6d 61 6e 20 52 | 65 73 6f 75 72 63 65 73 | Human R|esources|
|00004bd0| 20 61 62 6f 75 74 20 61 | 6e 20 61 6c 74 65 72 6e | about a|n altern|
|00004be0| 61 74 65 20 6a 6f 62 20 | 69 6e 20 79 6f 75 72 20 |ate job |in your |
|00004bf0| 61 72 65 61 2c 20 6f 72 | 20 69 66 20 6f 6e 65 20 |area, or| if one |
|00004c00| 63 61 6e d5 74 20 62 65 | 20 66 6f 75 6e 64 2c 20 |can.t be| found, |
|00004c10| 69 6e 20 61 6e 6f 74 68 | 65 72 20 67 72 6f 75 70 |in anoth|er group|
|00004c20| 2e 20 20 49 66 20 6e 6f | 20 61 6c 74 65 72 6e 61 |.  If no| alterna|
|00004c30| 74 65 20 6a 6f 62 20 63 | 61 6e 20 62 65 20 66 6f |te job c|an be fo|
|00004c40| 75 6e 64 20 74 68 65 20 | 65 6d 70 6c 6f 79 65 65 |und the |employee|
|00004c50| 20 77 69 6c 6c 20 6e 65 | 65 64 20 74 6f 20 72 65 | will ne|ed to re|
|00004c60| 63 75 70 65 72 61 74 65 | 20 61 74 20 68 6f 6d 65 |cuperate| at home|
|00004c70| 2e 0d 09 49 66 20 74 68 | 65 20 6a 6f 62 20 68 61 |...If th|e job ha|
|00004c80| 73 20 62 65 65 6e 20 66 | 69 6c 6c 65 64 20 6f 72 |s been f|illed or|
|00004c90| 20 65 6c 69 6d 69 6e 61 | 74 65 64 20 64 75 65 20 | elimina|ted due |
|00004ca0| 74 6f 20 62 75 73 69 6e | 65 73 73 20 6e 65 65 64 |to busin|ess need|
|00004cb0| 2c 20 6f 72 20 69 66 20 | 74 68 65 20 65 6d 70 6c |, or if |the empl|
|00004cc0| 6f 79 65 65 20 63 61 6e | 6e 6f 74 20 70 65 72 66 |oyee can|not perf|
|00004cd0| 6f 72 6d 20 68 69 73 20 | 6f 72 20 68 65 72 20 66 |orm his |or her f|
|00004ce0| 6f 72 6d 65 72 20 6a 6f | 62 20 64 75 65 20 74 6f |ormer jo|b due to|
|00004cf0| 20 6d 65 64 69 63 61 6c | 20 72 65 73 74 72 69 63 | medical| restric|
|00004d00| 74 69 6f 6e 73 20 65 76 | 65 6e 20 77 69 74 68 20 |tions ev|en with |
|00004d10| 72 65 61 73 6f 6e 61 62 | 6c 65 20 61 63 63 6f 6d |reasonab|le accom|
|00004d20| 6d 6f 64 61 74 69 6f 6e | 20 66 6f 6c 6c 6f 77 69 |modation| followi|
|00004d30| 6e 67 20 61 20 72 65 6c | 65 61 73 65 20 62 79 20 |ng a rel|ease by |
|00004d40| 74 68 65 20 65 6d 70 6c | 6f 79 65 65 d5 73 20 70 |the empl|oyee.s p|
|00004d50| 68 79 73 69 63 69 61 6e | 20 74 6f 20 72 65 74 75 |hysician| to retu|
|00004d60| 72 6e 20 74 6f 20 77 6f | 72 6b 2c 20 74 68 61 74 |rn to wo|rk, that|
|00004d70| 20 65 6d 70 6c 6f 79 65 | 65 20 6d 61 79 20 62 65 | employe|e may be|
|00004d80| 20 72 65 64 65 70 6c 6f | 79 65 64 20 61 6e 64 20 | redeplo|yed and |
|00004d90| 65 6c 69 67 69 62 6c 65 | 20 74 6f 20 72 65 63 65 |eligible| to rece|
|00004da0| 69 76 65 20 63 6f 6d 70 | 65 6e 73 61 74 69 6f 6e |ive comp|ensation|
|00004db0| 20 61 6e 64 20 62 65 6e | 65 66 69 74 73 20 70 65 | and ben|efits pe|
|00004dc0| 72 20 41 70 70 6c 65 d5 | 73 20 52 65 64 65 70 6c |r Apple.|s Redepl|
|00004dd0| 6f 79 6d 65 6e 74 20 50 | 6f 6c 69 63 79 2e 20 20 |oyment P|olicy.  |
|00004de0| 49 66 20 74 68 65 20 65 | 6d 70 6c 6f 79 65 65 20 |If the e|mployee |
|00004df0| 63 61 6e 6e 6f 74 20 72 | 65 74 75 72 6e 20 74 6f |cannot r|eturn to|
|00004e00| 20 68 69 73 20 6f 72 20 | 68 65 72 20 70 72 65 2d | his or |her pre-|
|00004e10| 69 6e 6a 75 72 79 20 6a | 6f 62 20 62 65 63 61 75 |injury j|ob becau|
|00004e20| 73 65 20 6f 66 20 6d 65 | 64 69 63 61 6c 20 72 65 |se of me|dical re|
|00004e30| 73 74 72 69 63 74 69 6f | 6e 73 20 74 68 65 79 20 |strictio|ns they |
|00004e40| 6d 61 79 20 61 6c 73 6f | 20 62 65 20 65 6c 69 67 |may also| be elig|
|00004e50| 69 62 6c 65 20 66 6f 72 | 20 77 6f 72 6b 65 72 73 |ible for| workers|
|00004e60| 20 63 6f 6d 70 65 6e 73 | 61 74 69 6f 6e 20 76 6f | compens|ation vo|
|00004e70| 63 61 74 69 6f 6e 61 6c | 20 72 65 68 61 62 69 6c |cational| rehabil|
|00004e80| 69 74 61 74 69 6f 6e 20 | 62 65 6e 65 66 69 74 73 |itation |benefits|
|00004e90| 2e 0d 0d 0d 09 49 6e 20 | 70 6c 61 6e 6e 69 6e 67 |.....In |planning|
|00004ea0| 20 66 6f 72 20 61 6e 20 | 65 6d 70 6c 6f 79 65 65 | for an |employee|
|00004eb0| d5 73 20 72 65 64 65 70 | 6c 6f 79 6d 65 6e 74 20 |.s redep|loyment |
|00004ec0| 79 6f 75 20 73 68 6f 75 | 6c 64 20 63 6f 6e 74 61 |you shou|ld conta|
|00004ed0| 63 74 20 79 6f 75 72 20 | 48 52 20 4c 69 61 69 73 |ct your |HR Liais|
|00004ee0| 6f 6e 2c 20 74 68 65 20 | 4d 75 6c 74 69 63 75 6c |on, the |Multicul|
|00004ef0| 74 75 72 61 6c 20 50 72 | 6f 67 72 61 6d 73 20 44 |tural Pr|ograms D|
|00004f00| 65 70 61 72 74 6d 65 6e | 74 2c 20 61 6e 64 2f 6f |epartmen|t, and/o|
|00004f10| 72 20 74 68 65 20 65 6d | 70 6c 6f 79 65 65 d5 73 |r the em|ployee.s|
|00004f20| 20 66 75 74 75 72 65 20 | 52 65 73 6f 75 72 63 65 | future |Resource|
|00004f30| 20 43 65 6e 74 65 72 20 | 41 64 76 69 73 6f 72 20 | Center |Advisor |
|00004f40| 69 6e 20 6f 72 64 65 72 | 20 74 68 61 74 20 61 73 |in order| that as|
|00004f50| 73 69 73 74 61 6e 63 65 | 20 6d 61 79 20 62 65 20 |sistance| may be |
|00004f60| 70 72 6f 76 69 64 65 64 | 20 74 6f 20 74 68 65 20 |provided| to the |
|00004f70| 65 6d 70 6c 6f 79 65 65 | 2c 20 69 66 20 68 69 73 |employee|, if his|
|00004f80| 2f 68 65 72 20 6d 65 64 | 69 63 61 6c 20 63 6f 6e |/her med|ical con|
|00004f90| 64 69 74 69 6f 6e 20 77 | 61 72 72 61 6e 74 73 2c |dition w|arrants,|
|00004fa0| 20 69 6e 20 69 64 65 6e | 74 69 66 79 69 6e 67 20 | in iden|tifying |
|00004fb0| 61 70 70 72 6f 70 72 69 | 61 74 65 20 61 6e 64 20 |appropri|ate and |
|00004fc0| 72 65 61 73 6f 6e 61 62 | 6c 65 20 61 63 63 6f 6d |reasonab|le accom|
|00004fd0| 6d 6f 64 61 74 69 6f 6e | 73 2c 20 6f 72 20 63 6f |modation|s, or co|
|00004fe0| 6e 63 65 72 6e 69 6e 67 | 20 76 61 63 61 6e 74 20 |ncerning| vacant |
|00004ff0| 70 6f 73 69 74 69 6f 6e | 73 20 66 6f 72 20 77 68 |position|s for wh|
|00005000| 69 63 68 20 74 68 65 20 | 65 6d 70 6c 6f 79 65 65 |ich the |employee|
|00005010| 20 6d 61 79 20 62 65 20 | 71 75 61 6c 69 66 69 65 | may be |qualifie|
|00005020| 64 20 61 66 74 65 72 20 | 72 65 61 73 6f 6e 61 62 |d after |reasonab|
|00005030| 6c 65 20 61 63 63 6f 6d | 6d 6f 64 61 74 69 6f 6e |le accom|modation|
|00005040| 2e 0d 0d 31 30 2e 20 20 | 41 66 74 65 72 20 74 68 |...10.  |After th|
|00005050| 65 20 65 6d 70 6c 6f 79 | 65 65 20 72 65 74 75 72 |e employ|ee retur|
|00005060| 6e 73 20 74 6f 20 77 6f | 72 6b 2c 20 74 68 65 20 |ns to wo|rk, the |
|00005070| 65 6d 70 6c 6f 79 65 65 | 20 73 68 6f 75 6c 64 20 |employee| should |
|00005080| 61 64 76 69 73 65 20 79 | 6f 75 20 6f 66 20 61 6e |advise y|ou of an|
|00005090| 79 20 64 6f 63 74 6f 72 | d5 73 20 61 70 70 6f 69 |y doctor|.s appoi|
|000050a0| 6e 74 6d 65 6e 74 73 2e | 20 20 49 74 20 69 73 20 |ntments.|  It is |
|000050b0| 41 70 70 6c 65 d5 73 20 | 70 72 61 63 74 69 63 65 |Apple.s |practice|
|000050c0| 20 74 68 61 74 20 74 68 | 65 20 65 6d 70 6c 6f 79 | that th|e employ|
|000050d0| 65 65 20 77 69 6c 6c 20 | 72 65 63 65 69 76 65 20 |ee will |receive |
|000050e0| 66 75 6c 6c 20 73 61 6c | 61 72 79 20 77 68 69 6c |full sal|ary whil|
|000050f0| 65 20 61 74 74 65 6e 64 | 69 6e 67 20 61 6e 79 20 |e attend|ing any |
|00005100| 64 6f 63 74 6f 72 20 61 | 70 70 6f 69 6e 74 6d 65 |doctor a|ppointme|
|00005110| 6e 74 73 20 72 65 6c 61 | 74 65 64 20 74 6f 20 74 |nts rela|ted to t|
|00005120| 68 65 20 57 6f 72 6b 65 | 72 73 d5 20 43 6f 6d 70 |he Worke|rs. Comp|
|00005130| 65 6e 73 61 74 69 6f 6e | 20 69 6e 6a 75 72 79 20 |ensation| injury |
|00005140| 63 6c 61 69 6d d1 69 74 | 20 69 73 20 6e 6f 74 20 |claim.it| is not |
|00005150| 6e 65 63 65 73 73 61 72 | 79 20 74 6f 20 75 73 65 |necessar|y to use|
|00005160| 20 70 65 72 73 6f 6e 61 | 6c 20 6f 72 20 73 69 63 | persona|l or sic|
|00005170| 6b 20 74 69 6d 65 20 66 | 6f 72 20 74 68 65 73 65 |k time f|or these|
|00005180| 20 76 69 73 69 74 73 20 | 6f 72 20 74 6f 20 73 63 | visits |or to sc|
|00005190| 68 65 64 75 6c 65 20 74 | 68 65 6d 20 64 75 72 69 |hedule t|hem duri|
|000051a0| 6e 67 20 6c 75 6e 63 68 | 20 6f 72 20 62 72 65 61 |ng lunch| or brea|
|000051b0| 6b 20 74 69 6d 65 2e 20 | 20 45 58 43 45 50 54 49 |k time. | EXCEPTI|
|000051c0| 4f 4e 3a 20 49 66 20 74 | 68 65 20 69 6e 73 75 72 |ON: If t|he insur|
|000051d0| 61 6e 63 65 20 63 6f 6d | 70 61 6e 79 20 73 65 74 |ance com|pany set|
|000051e0| 73 20 75 70 20 61 20 6d | 65 64 69 63 61 6c 20 65 |s up a m|edical e|
|000051f0| 76 61 6c 75 61 74 69 6f | 6e 20 74 68 65 20 69 6e |valuatio|n the in|
|00005200| 6a 75 72 65 64 20 65 6d | 70 6c 6f 79 65 65 20 77 |jured em|ployee w|
|00005210| 69 6c 6c 20 62 65 20 70 | 61 69 64 20 6f 6e 65 20 |ill be p|aid one |
|00005220| 64 61 79 20 74 65 6d 70 | 6f 72 61 72 79 20 64 69 |day temp|orary di|
|00005230| 73 61 62 69 6c 69 74 79 | 2e 20 20 4e 6f 6e 2d 65 |sability|.  Non-e|
|00005240| 78 65 6d 70 74 20 65 6d | 70 6c 6f 79 65 65 73 20 |xempt em|ployees |
|00005250| 73 68 6f 75 6c 64 20 69 | 6e 64 69 63 61 74 65 20 |should i|ndicate |
|00005260| 57 6f 72 6b 65 72 73 d5 | 20 43 6f 6d 70 65 6e 73 |Workers.| Compens|
|00005270| 61 74 69 6f 6e 20 68 6f | 75 72 73 20 66 6f 72 20 |ation ho|urs for |
|00005280| 74 68 65 20 74 69 6d 65 | 20 73 70 65 6e 74 20 61 |the time| spent a|
|00005290| 74 74 65 6e 64 69 6e 67 | 20 73 75 63 68 20 6d 65 |ttending| such me|
|000052a0| 64 69 63 61 6c 20 65 76 | 61 6c 75 61 74 69 6f 6e |dical ev|aluation|
|000052b0| 73 2e 0d 0d 20 09 49 66 | 20 79 6f 75 20 68 61 76 |s... .If| you hav|
|000052c0| 65 20 61 6e 79 20 71 75 | 65 73 74 69 6f 6e 73 2c |e any qu|estions,|
|000052d0| 20 70 6c 65 61 73 65 20 | 63 6f 6e 74 61 63 74 20 | please |contact |
|000052e0| 41 70 70 6c 65 d5 73 20 | 57 6f 72 6b 65 72 73 20 |Apple.s |Workers |
|000052f0| 43 6f 6d 70 65 6e 73 61 | 74 69 6f 6e 20 43 6c 61 |Compensa|tion Cla|
|00005300| 69 6d 73 20 41 64 6d 69 | 6e 69 73 74 72 61 74 6f |ims Admi|nistrato|
|00005310| 72 20 61 74 20 28 34 30 | 38 29 39 37 34 2d 33 35 |r at (40|8)974-35|
|00005320| 30 39 2e 20 0d 0d 0d 14 | 00 00 03 36 00 29 00 00 |09. ....|...6.)..|
|00005330| 00 00 00 0c 00 09 00 14 | 01 00 00 0a 00 00 00 00 |........|........|
|00005340| 00 00 00 00 00 27 00 0c | 00 09 00 14 00 00 00 0a |.....'..|........|
|00005350| 00 00 00 00 00 00 00 00 | 00 ff 00 0c 00 09 00 14 |........|........|
|00005360| 00 00 00 0c 00 00 00 00 | 00 00 00 00 01 00 00 0c |........|........|
|00005370| 00 09 00 14 00 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|00005380| 01 01 00 0c 00 09 00 14 | 01 25 00 0a 00 00 00 00 |........|.%......|
|00005390| 00 00 00 00 01 03 00 0c | 00 09 00 14 00 25 00 0a |........|.....%..|
|000053a0| 00 00 00 00 00 00 00 00 | 01 04 00 0c 00 09 00 14 |........|........|
|000053b0| 00 00 00 0a 00 00 00 00 | 00 00 00 00 01 39 00 0c |........|.....9..|
|000053c0| 00 09 00 14 01 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|000053d0| 01 3a 00 0c 00 09 00 14 | 00 25 00 0a 00 00 00 00 |.:......|.%......|
|000053e0| 00 00 00 00 02 cd 00 0c | 00 09 00 14 00 00 00 0a |........|........|
|000053f0| 00 00 00 00 00 00 00 00 | 02 df 00 0c 00 09 00 14 |........|........|
|00005400| 00 25 00 0a 00 00 00 00 | 00 00 00 00 04 30 00 0c |.%......|.....0..|
|00005410| 00 09 00 14 01 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|00005420| 04 31 00 0c 00 09 00 14 | 01 00 00 0a 00 00 00 00 |.1......|........|
|00005430| 00 00 00 00 04 36 00 0c | 00 09 00 14 00 00 00 0a |.....6..|........|
|00005440| 00 00 00 00 00 00 00 00 | 05 13 00 0c 00 09 00 14 |........|........|
|00005450| 00 25 00 0a 00 00 00 00 | 00 00 00 00 05 d6 00 0c |.%......|........|
|00005460| 00 09 00 14 01 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|00005470| 05 dc 00 0c 00 09 00 14 | 00 25 00 0a 00 00 00 00 |........|.%......|
|00005480| 00 00 00 00 06 c8 00 0c | 00 09 00 14 01 25 00 0a |........|.....%..|
|00005490| 00 00 00 00 00 00 00 00 | 06 ca 00 0c 00 09 00 14 |........|........|
|000054a0| 00 25 00 0a 00 00 00 00 | 00 00 00 00 06 cc 00 0c |.%......|........|
|000054b0| 00 09 00 14 01 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|000054c0| 06 ed 00 0c 00 09 00 14 | 00 25 00 0a 00 00 00 00 |........|.%......|
|000054d0| 00 00 00 00 07 07 00 0c | 00 09 00 14 01 25 00 0a |........|.....%..|
|000054e0| 00 00 00 00 00 00 00 00 | 07 09 00 0c 00 09 00 14 |........|........|
|000054f0| 00 25 00 0a 00 00 00 00 | 00 00 00 00 07 22 00 0c |.%......|....."..|
|00005500| 00 09 00 14 01 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|00005510| 07 2e 00 0c 00 09 00 14 | 00 00 00 0a 00 00 00 00 |........|........|
|00005520| 00 00 00 00 07 48 00 0c | 00 09 00 14 00 25 00 0a |.....H..|.....%..|
|00005530| 00 00 00 00 00 00 00 00 | 08 3a 00 0c 00 09 00 14 |........|.:......|
|00005540| 01 25 00 0a 00 00 00 00 | 00 00 00 00 08 3e 00 0c |.%......|.....>..|
|00005550| 00 09 00 14 00 00 00 0a | 00 00 00 00 00 00 00 00 |........|........|
|00005560| 08 4f 00 0c 00 09 00 14 | 01 25 00 0a 00 00 00 00 |.O......|.%......|
|00005570| 00 00 00 00 08 6f 00 0c | 00 09 00 14 00 25 00 0a |.....o..|.....%..|
|00005580| 00 00 00 00 00 00 00 00 | 09 6e 00 0c 00 09 00 14 |........|.n......|
|00005590| 01 25 00 0a 00 00 00 00 | 00 00 00 00 09 70 00 0c |.%......|.....p..|
|000055a0| 00 09 00 14 00 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|000055b0| 09 96 00 0c 00 09 00 14 | 01 25 00 0a 00 00 00 00 |........|.%......|
|000055c0| 00 00 00 00 09 a5 00 0c | 00 09 00 14 00 25 00 0a |........|.....%..|
|000055d0| 00 00 00 00 00 00 00 00 | 09 dc 00 0c 00 09 00 14 |........|........|
|000055e0| 01 25 00 0a 00 00 00 00 | 00 00 00 00 0a 00 00 0c |.%......|........|
|000055f0| 00 09 00 14 00 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|00005600| 0a 95 00 0c 00 09 00 14 | 01 25 00 0a 00 00 00 00 |........|.%......|
|00005610| 00 00 00 00 0a b8 00 0c | 00 09 00 14 00 25 00 0a |........|.....%..|
|00005620| 00 00 00 00 00 00 00 00 | 0c 12 00 0c 00 09 00 14 |........|........|
|00005630| 00 00 00 0a 00 00 00 00 | 00 00 00 00 0c 14 00 0c |........|........|
|00005640| 00 09 00 14 01 25 00 0a | 00 00 00 00 00 00 00 00 |.....%..|........|
|00005650| 0c 35 00 0c 00 09 00 14 | 00 25 00 0a 00 00 00 00 |.5......|.%......|
|00005660| 00 00 00 07 00 00 11 50 | 00 60 04 dc 0c 50 09 70 |.......P|.`...P.p|
|00005670| 00 01 00 00 ff ff ff ff | ff ff ff ff 00 01 00 00 |........|........|
|00005680| 00 00 00 00 00 02 00 60 | 04 dc 0c 50 09 70 00 00 |.......`|...P.p..|
|00005690| 00 00 00 14 00 0a 00 01 | 00 00 00 01 00 01 00 40 |........|.......@|
|000056a0| 0e 90 36 2e 20 09 57 68 | 65 6e 20 79 6f 75 20 62 |..6. .Wh|en you b|
|000056b0| 65 63 6f 6d 65 20 61 77 | 61 72 65 20 74 68 61 74 |ecome aw|are that|
|000056c0| 20 74 68 65 20 65 6d 70 | 6c 6f 79 65 65 20 77 69 | the emp|loyee wi|
|000056d0| 6c 6c 20 62 65 20 75 6e | 61 62 6c 65 20 74 6f 20 |ll be un|able to |
|000056e0| 72 65 74 75 72 6e 20 74 | 6f 20 77 6f 72 6b 20 66 |return t|o work f|
|000056f0| 6f 72 20 73 6f 6d 65 20 | 74 69 6d 65 20 6e 6f 74 |or some |time not|
|00005700| 69 66 79 20 48 75 6d 61 | 6e 20 52 65 73 6f 75 72 |ify Huma|n Resour|
|00005710| 63 65 73 20 61 6e 64 20 | 52 69 73 6b 20 4d 61 6e |ces and |Risk Man|
|00005720| 61 67 65 6d 65 6e 74 2e | 20 20 49 66 20 79 6f 75 |agement.|  If you|
|00005730| 72 20 65 6d 70 6c 6f 79 | 65 65 d5 73 20 64 6f 63 |r employ|ee.s doc|
|00005740| 74 6f 72 20 63 65 72 74 | 69 66 69 65 73 20 74 68 |tor cert|ifies th|
|00005750| 61 74 20 74 68 65 20 65 | 6d 70 6c 6f 79 65 65 20 |at the e|mployee |
|00005760| 77 69 6c 6c 20 62 65 20 | 61 77 61 79 20 66 72 6f |will be |away fro|
|00005770| 6d 20 77 6f 72 6b 20 66 | 6f 72 20 6d 6f 72 65 20 |m work f|or more |
|00005780| 74 68 61 6e 20 73 65 76 | 65 6e 20 63 6f 6e 73 65 |than sev|en conse|
|00005790| 63 75 74 69 76 65 20 64 | 61 79 73 2c 20 74 68 65 |cutive d|ays, the|
|000057a0| 20 65 6d 70 6c 6f 79 65 | 65 20 73 68 6f 75 6c 64 | employe|e should|
|000057b0| 20 61 72 72 61 6e 67 65 | 20 66 6f 72 20 61 20 4d | arrange| for a M|
|000057c0| 65 64 69 63 61 6c 20 4c | 65 61 76 65 20 6f 66 20 |edical L|eave of |
|000057d0| 41 62 73 65 6e 63 65 2c | 20 61 6e 64 20 73 68 6f |Absence,| and sho|
|000057e0| 75 6c 64 20 61 70 70 6c | 79 20 66 6f 72 20 73 68 |uld appl|y for sh|
|000057f0| 6f 72 74 20 74 65 72 6d | 20 64 69 73 61 62 69 6c |ort term| disabil|
|00005800| 69 74 79 20 62 65 6e 65 | 66 69 74 73 2e 0d 20 20 |ity bene|fits..  |
|00005810| 4e 4f 4e 2d 45 58 45 4d | 50 54 20 65 6d 70 6c 6f |NON-EXEM|PT emplo|
|00005820| 79 65 65 73 20 73 68 6f | 75 6c 64 20 63 6f 6e 74 |yees sho|uld cont|
|00005830| 69 6e 75 65 20 74 6f 20 | 66 69 6c 6c 20 6f 75 74 |inue to |fill out|
|00005840| 20 61 20 74 69 6d 65 63 | 61 72 64 20 64 75 72 69 | a timec|ard duri|
|00005850| 6e 67 20 74 68 65 20 74 | 69 6d 65 20 74 68 65 79 |ng the t|ime they|
|00005860| 20 61 72 65 20 61 62 73 | 65 6e 74 20 64 75 65 20 | are abs|ent due |
|00005870| 74 6f 20 61 20 77 6f 72 | 6b 2d 72 65 6c 61 74 65 |to a wor|k-relate|
|00005880| 64 20 61 63 63 69 64 65 | 6e 74 2e 20 20 4d 61 6b |d accide|nt.  Mak|
|00005890| 65 20 73 75 72 65 20 74 | 68 65 20 74 69 6d 65 63 |e sure t|he timec|
|000058a0| 61 72 64 20 73 70 65 63 | 69 66 69 65 73 20 57 6f |ard spec|ifies Wo|
|000058b0| 72 6b 65 72 73 d5 20 43 | 6f 6d 70 65 6e 73 61 74 |rkers. C|ompensat|
|000058c0| 69 6f 6e 20 68 6f 75 72 | 73 20 6e 6f 74 20 72 65 |ion hour|s not re|
|000058d0| 67 75 6c 61 72 20 68 6f | 75 72 73 2c 20 73 69 63 |gular ho|urs, sic|
|000058e0| 6b 20 74 69 6d 65 2c 20 | 6f 72 20 76 61 63 61 74 |k time, |or vacat|
|000058f0| 69 6f 6e 2e 0d 20 45 58 | 45 4d 50 54 20 65 6d 70 |ion.. EX|EMPT emp|
|00005900| 6c 6f 79 65 65 73 20 73 | 68 6f 75 6c 64 20 6e 6f |loyees s|hould no|
|00005910| 74 20 68 61 6e 64 20 69 | 6e 20 61 6e 79 20 56 61 |t hand i|n any Va|
|00005920| 63 61 74 69 6f 6e 2f 53 | 69 63 6b 20 41 75 74 68 |cation/S|ick Auth|
|00005930| 6f 72 69 7a 61 74 69 6f | 6e 20 66 6f 72 6d 73 20 |orizatio|n forms |
|00005940| 66 6f 72 20 77 6f 72 6b | 2d 72 65 6c 61 74 65 64 |for work|-related|
|00005950| 20 69 6e 6a 75 72 79 2f | 69 6c 6c 6e 65 73 73 20 | injury/|illness |
|00005960| 61 62 73 65 6e 63 65 73 | 2e 0d 0d 37 2e 20 09 54 |absences|...7. .T|
|00005970| 68 65 72 65 20 69 73 20 | 61 20 6d 61 6e 64 61 74 |here is |a mandat|
|00005980| 6f 72 79 20 77 61 69 74 | 69 6e 67 20 70 65 72 69 |ory wait|ing peri|
|00005990| 6f 64 d1 77 68 69 63 68 | 20 76 61 72 69 65 73 20 |od.which| varies |
|000059a0| 66 72 6f 6d 20 73 74 61 | 74 65 20 74 6f 20 73 74 |from sta|te to st|
|000059b0| 61 74 65 d1 62 65 66 6f | 72 65 20 61 20 63 6f 6d |ate.befo|re a com|
|000059c0| 70 6c 65 74 65 20 64 69 | 73 61 62 69 6c 69 74 79 |plete di|sability|
|000059d0| 20 70 61 79 6d 65 6e 74 | 20 73 63 68 65 64 75 6c | payment| schedul|
|000059e0| 65 20 63 61 6e 20 62 65 | 20 69 6e 69 74 69 61 74 |e can be| initiat|
|000059f0| 65 64 2e 20 20 44 75 72 | 69 6e 67 20 74 68 69 73 |ed.  Dur|ing this|
|00005a00| 20 77 61 69 74 69 6e 67 | 20 70 65 72 69 6f 64 20 | waiting| period |
|00005a10| 41 70 70 6c 65 20 77 69 | 6c 6c 20 70 61 79 20 74 |Apple wi|ll pay t|
|00005a20| 68 65 20 65 6d 70 6c 6f | 79 65 65 d5 73 20 66 75 |he emplo|yee.s fu|
|00005a30| 6c 6c 20 73 61 6c 61 72 | 79 2e 20 20 49 66 20 79 |ll salar|y.  If y|
|00005a40| 6f 75 20 73 75 73 70 65 | 63 74 20 74 68 65 20 65 |ou suspe|ct the e|
|00005a50| 6d 70 6c 6f 79 65 65 20 | 77 69 6c 6c 20 62 65 20 |mployee |will be |
|00005a60| 6f 66 66 20 77 6f 72 6b | 20 6c 6f 6e 67 65 72 20 |off work| longer |
|00005a70| 74 68 61 6e 20 74 68 65 | 20 77 61 69 74 69 6e 67 |than the| waiting|
|00005a80| 20 70 65 72 69 6f 64 20 | 6d 61 6b 65 20 73 75 72 | period |make sur|
|00005a90| 65 20 79 6f 75 20 73 65 | 6e 64 20 74 68 65 20 44 |e you se|nd the D|
|00005aa0| 6f 63 74 6f 72 d5 73 20 | 46 69 72 73 74 20 52 65 |octor.s |First Re|
|00005ab0| 70 6f 72 74 20 6f 66 20 | 49 6e 6a 75 72 79 20 74 |port of |Injury t|
|00005ac0| 6f 20 48 75 6d 61 6e 20 | 52 65 73 6f 75 72 63 65 |o Human |Resource|
|00005ad0| 73 20 61 6e 64 20 52 69 | 73 6b 20 4d 61 6e 61 67 |s and Ri|sk Manag|
|00005ae0| 65 6d 65 6e 74 20 61 73 | 20 73 6f 6f 6e 20 61 73 |ement as| soon as|
|00005af0| 20 70 6f 73 73 69 62 6c | 65 20 61 6e 64 20 6e 6f | possibl|e and no|
|00005b00| 20 6c 61 74 65 72 20 74 | 68 61 6e 20 74 68 65 20 | later t|han the |
|00005b10| 39 74 68 20 64 61 79 20 | 61 66 74 65 72 20 74 68 |9th day |after th|
|00005b20| 65 20 69 6e 6a 75 72 79 | 2e 20 20 48 75 6d 61 6e |e injury|.  Human|
|00005b30| 20 52 65 73 6f 75 72 63 | 65 73 20 6e 65 65 64 73 | Resourc|es needs|
|00005b40| 20 74 68 69 73 20 66 6f | 72 6d 20 74 6f 20 70 72 | this fo|rm to pr|
|00005b50| 6f 63 65 73 73 20 61 20 | 50 65 72 73 6f 6e 6e 65 |ocess a |Personne|
|00005b60| 6c 20 41 63 74 69 6f 6e | 20 4e 6f 74 69 63 65 20 |l Action| Notice |
|00005b70| 77 68 69 63 68 20 69 73 | 20 72 65 71 75 69 72 65 |which is| require|
|00005b80| 64 20 69 6e 20 6f 72 64 | 65 72 20 66 6f 72 20 74 |d in ord|er for t|
|00005b90| 68 65 20 65 6d 70 6c 6f | 79 65 65 20 74 6f 20 72 |he emplo|yee to r|
|00005ba0| 65 63 65 69 76 65 20 61 | 64 64 69 74 69 6f 6e 61 |eceive a|dditiona|
|00005bb0| 6c 20 64 69 73 61 62 69 | 6c 69 74 79 20 70 61 79 |l disabi|lity pay|
|00005bc0| 6d 65 6e 74 73 2e 0d 0d | 38 2e 20 09 44 75 72 69 |ments...|8. .Duri|
|00005bd0| 6e 67 20 74 68 65 20 66 | 69 72 73 74 20 39 30 20 |ng the f|irst 90 |
|00005be0| 64 61 79 73 20 6f 66 20 | 74 68 65 20 65 6d 70 6c |days of |the empl|
|00005bf0| 6f 79 65 65 d5 73 20 6d | 65 64 69 63 61 6c 20 20 |oyee.s m|edical  |
|00005c00| 6c 65 61 76 65 20 6f 66 | 20 61 62 73 65 6e 63 65 |leave of| absence|
|00005c10| 20 6d 61 6b 65 20 61 20 | 70 6f 69 6e 74 20 74 6f | make a |point to|
|00005c20| 20 67 65 74 20 69 6e 20 | 74 6f 75 63 68 20 77 69 | get in |touch wi|
|00005c30| 74 68 20 68 69 6d 20 6f | 72 20 68 65 72 20 77 65 |th him o|r her we|
|00005c40| 65 6b 6c 79 2e 20 20 53 | 74 61 79 20 69 6e 66 6f |ekly.  S|tay info|
|00005c50| 72 6d 65 64 20 61 62 6f | 75 74 20 74 68 65 20 65 |rmed abo|ut the e|
|00005c60| 6d 70 6c 6f 79 65 65 d5 | 73 20 6d 65 64 69 63 61 |mployee.|s medica|
|00005c70| 6c 20 74 72 65 61 74 6d | 65 6e 74 20 61 6e 64 20 |l treatm|ent and |
|00005c80| 67 69 76 65 20 72 65 67 | 75 6c 61 72 20 75 70 64 |give reg|ular upd|
|00005c90| 61 74 65 73 20 74 6f 20 | 48 75 6d 61 6e 20 52 65 |ates to |Human Re|
|00005ca0| 73 6f 75 72 63 65 73 20 | 61 6e 64 20 52 69 73 6b |sources |and Risk|
|00005cb0| 20 4d 61 6e 61 67 65 6d | 65 6e 74 20 6f 6e 20 74 | Managem|ent on t|
|00005cc0| 68 65 20 65 6d 70 6c 6f | 79 65 65 d5 73 20 70 72 |he emplo|yee.s pr|
|00005cd0| 6f 67 72 65 73 73 2e 0d | 20 20 59 6f 75 20 6d 61 |ogress..|  You ma|
|00005ce0| 79 20 6e 65 65 64 20 74 | 6f 20 68 69 72 65 20 61 |y need t|o hire a|
|00005cf0| 20 74 65 6d 70 6f 72 61 | 72 79 20 65 6d 70 6c 6f | tempora|ry emplo|
|00005d00| 79 65 65 20 77 68 69 6c | 65 20 79 6f 75 72 20 65 |yee whil|e your e|
|00005d10| 6d 70 6c 6f 79 65 65 20 | 69 73 20 6f 75 74 20 6f |mployee |is out o|
|00005d20| 6e 20 61 20 77 6f 72 6b | 65 72 73 d5 20 63 6f 6d |n a work|ers. com|
|00005d30| 70 65 6e 73 61 74 69 6f | 6e 20 69 6e 6a 75 72 79 |pensatio|n injury|
|00005d40| 2e 20 20 4f 72 2c 20 62 | 75 73 69 6e 65 73 73 20 |.  Or, b|usiness |
|00005d50| 6e 65 65 64 73 20 6d 61 | 79 20 72 65 71 75 69 72 |needs ma|y requir|
|00005d60| 65 20 74 68 61 74 20 79 | 6f 75 20 68 69 72 65 20 |e that y|ou hire |
|00005d70| 61 20 72 65 67 75 6c 61 | 72 20 66 75 6c 6c 20 74 |a regula|r full t|
|00005d80| 69 6d 65 20 65 6d 70 6c | 6f 79 65 65 20 74 6f 20 |ime empl|oyee to |
|00005d90| 66 69 6c 6c 20 74 68 61 | 74 20 70 6f 73 69 74 69 |fill tha|t positi|
|00005da0| 6f 6e 2e 20 20 49 6e 20 | 65 69 74 68 65 72 20 63 |on.  In |either c|
|00005db0| 61 73 65 2c 20 61 73 6b | 20 48 75 6d 61 6e 20 52 |ase, ask| Human R|
|00005dc0| 65 73 6f 75 72 63 65 73 | 20 66 6f 72 20 61 73 73 |esources| for ass|
|00005dd0| 69 73 74 61 6e 63 65 2e | 20 0d 0d 39 2e 09 42 65 |istance.| ..9..Be|
|00005de0| 66 6f 72 65 20 74 68 65 | 20 65 6d 70 6c 6f 79 65 |fore the| employe|
|00005df0| 65 20 72 65 74 75 72 6e | 73 20 74 6f 20 77 6f 72 |e return|s to wor|
|00005e00| 6b 20 68 65 20 6f 72 20 | 73 68 65 20 6e 65 65 64 |k he or |she need|
|00005e10| 73 20 74 6f 20 70 72 6f | 76 69 64 65 20 79 6f 75 |s to pro|vide you|
|00005e20| 2c 20 52 69 73 6b 20 4d | 61 6e 61 67 65 6d 65 6e |, Risk M|anagemen|
|00005e30| 74 20 61 6e 64 20 48 75 | 6d 61 6e 20 52 65 73 6f |t and Hu|man Reso|
|00005e40| 75 72 63 65 73 20 77 69 | 74 68 20 61 20 77 72 69 |urces wi|th a wri|
|00005e50| 74 74 65 6e 20 44 6f 63 | 74 6f 72 d5 73 20 52 65 |tten Doc|tor.s Re|
|00005e60| 6c 65 61 73 65 20 61 6e | 64 20 73 68 6f 75 6c 64 |lease an|d should|
|00005e70| 20 63 6f 6e 73 75 6c 74 | 20 77 69 74 68 20 48 75 | consult| with Hu|
|00005e80| 6d 61 6e 20 52 65 73 6f | 75 72 63 65 73 20 74 6f |man Reso|urces to|
|00005e90| 20 64 65 74 65 72 6d 69 | 6e 65 20 77 68 65 74 68 | determi|ne wheth|
|00005ea0| 65 72 20 69 74 20 77 69 | 6c 6c 20 62 65 20 70 6f |er it wi|ll be po|
|00005eb0| 73 73 69 62 6c 65 20 74 | 6f 20 62 65 20 72 65 69 |ssible t|o be rei|
|00005ec0| 6e 73 74 61 74 65 64 20 | 61 74 20 74 68 65 20 70 |nstated |at the p|
|00005ed0| 72 65 2d 69 6e 6a 75 72 | 79 20 6a 6f 62 20 6f 72 |re-injur|y job or|
|00005ee0| 20 63 6f 6d 70 61 72 61 | 62 6c 65 20 6a 6f 62 2e | compara|ble job.|
|00005ef0| 0d 20 20 49 66 20 74 68 | 65 20 6a 6f 62 20 68 61 |.  If th|e job ha|
|00005f00| 73 20 62 65 65 6e 20 66 | 69 6c 6c 65 64 20 6f 72 |s been f|illed or|
|00005f10| 20 65 6c 69 6d 69 6e 61 | 74 65 64 20 64 75 65 20 | elimina|ted due |
|00005f20| 74 6f 20 62 75 73 69 6e | 65 73 73 20 6e 65 65 64 |to busin|ess need|
|00005f30| 2c 20 6f 72 20 69 66 20 | 74 68 65 20 65 6d 70 6c |, or if |the empl|
|00005f40| 6f 79 65 65 20 63 61 6e | 6e 6f 74 20 70 65 72 66 |oyee can|not perf|
|00005f50| 6f 72 6d 20 68 69 73 20 | 6f 72 20 68 65 72 20 66 |orm his |or her f|
|00005f60| 6f 72 6d 65 72 20 6a 6f | 62 20 64 75 65 20 74 6f |ormer jo|b due to|
|00005f70| 20 6d 65 64 69 63 61 6c | 20 72 65 73 74 72 69 63 | medical| restric|
|00005f80| 74 69 6f 6e 73 20 65 76 | 65 6e 20 77 69 74 68 20 |tions ev|en with |
|00005f90| 72 65 61 73 6f 6e 61 62 | 6c 65 20 61 63 63 6f 6d |reasonab|le accom|
|00005fa0| 6d 6f 64 61 74 69 6f 6e | 20 66 6f 6c 6c 6f 77 69 |modation| followi|
|00005fb0| 6e 67 20 61 20 72 65 6c | 65 61 73 65 20 62 79 20 |ng a rel|ease by |
|00005fc0| 74 68 65 20 65 6d 70 6c | 6f 79 65 65 d5 73 20 70 |the empl|oyee.s p|
|00005fd0| 68 79 73 69 63 69 61 6e | 20 74 6f 20 72 65 74 75 |hysician| to retu|
|00005fe0| 72 6e 20 74 6f 20 77 6f | 72 6b 2c 20 74 68 61 74 |rn to wo|rk, that|
|00005ff0| 20 65 6d 70 6c 6f 79 65 | 65 20 6d 61 79 20 62 65 | employe|e may be|
|00006000| 20 72 65 64 65 70 6c 6f | 79 65 64 20 61 6e 64 20 | redeplo|yed and |
|00006010| 65 6c 69 67 69 62 6c 65 | 20 74 6f 20 72 65 63 65 |eligible| to rece|
|00006020| 69 76 65 20 63 6f 6d 70 | 65 6e 73 61 74 69 6f 6e |ive comp|ensation|
|00006030| 20 61 6e 64 20 62 65 6e | 65 66 69 74 73 20 70 65 | and ben|efits pe|
|00006040| 72 20 41 70 70 6c 65 d5 | 73 20 52 65 64 65 70 6c |r Apple.|s Redepl|
|00006050| 6f 79 6d 65 6e 74 20 50 | 6f 6c 69 63 79 2e 20 20 |oyment P|olicy.  |
|00006060| 49 66 20 74 68 65 20 65 | 6d 70 6c 6f 79 65 65 20 |If the e|mployee |
|00006070| 63 61 6e 6e 6f 74 20 72 | 65 74 75 72 6e 20 74 6f |cannot r|eturn to|
|00006080| 20 68 69 73 20 6f 72 20 | 68 65 72 20 70 72 65 2d | his or |her pre-|
|00006090| 69 6e 6a 75 72 79 20 6a | 6f 62 20 62 65 63 61 75 |injury j|ob becau|
|000060a0| 73 65 20 6f 66 20 6d 65 | 64 69 63 61 6c 20 72 65 |se of me|dical re|
|000060b0| 73 74 72 69 63 74 69 6f | 6e 73 20 74 68 65 79 20 |strictio|ns they |
|000060c0| 6d 61 79 20 61 6c 73 6f | 20 62 65 20 65 6c 69 67 |may also| be elig|
|000060d0| 69 62 6c 65 20 66 6f 72 | 20 77 6f 72 6b 65 72 73 |ible for| workers|
|000060e0| 20 63 6f 6d 70 65 6e 73 | 61 74 69 6f 6e 20 76 6f | compens|ation vo|
|000060f0| 63 61 74 69 6f 6e 61 6c | 20 72 65 68 61 62 69 6c |cational| rehabil|
|00006100| 69 74 61 74 69 6f 6e 20 | 62 65 6e 65 66 69 74 73 |itation |benefits|
|00006110| 2e 0d 49 6e 20 70 6c 61 | 6e 6e 69 6e 67 20 66 6f |..In pla|nning fo|
|00006120| 72 20 61 6e 20 65 6d 70 | 6c 6f 79 65 65 d5 73 20 |r an emp|loyee.s |
|00006130| 72 65 64 65 70 6c 6f 79 | 6d 65 6e 74 20 79 6f 75 |redeploy|ment you|
|00006140| 20 73 68 6f 75 6c 64 20 | 63 6f 6e 74 61 63 74 20 | should |contact |
|00006150| 79 6f 75 72 20 48 52 20 | 4c 69 61 69 73 6f 6e 2c |your HR |Liaison,|
|00006160| 20 74 68 65 20 4d 75 6c | 74 69 63 75 6c 74 75 72 | the Mul|ticultur|
|00006170| 61 6c 20 50 72 6f 67 72 | 61 6d 73 20 44 65 70 61 |al Progr|ams Depa|
|00006180| 72 74 6d 65 6e 74 2c 20 | 61 6e 64 2f 6f 72 20 74 |rtment, |and/or t|
|00006190| 68 65 20 65 6d 70 6c 6f | 79 65 65 d5 73 20 66 75 |he emplo|yee.s fu|
|000061a0| 74 75 72 65 20 52 65 73 | 6f 75 72 63 65 20 43 65 |ture Res|ource Ce|
|000061b0| 6e 74 65 72 20 41 64 76 | 69 73 6f 72 20 69 6e 20 |nter Adv|isor in |
|000061c0| 6f 72 64 65 72 20 74 68 | 61 74 20 61 73 73 69 73 |order th|at assis|
|000061d0| 74 61 6e 63 65 20 6d 61 | 79 20 62 65 20 70 72 6f |tance ma|y be pro|
|000061e0| 76 69 64 65 64 20 74 6f | 20 74 68 65 20 65 6d 70 |vided to| the emp|
|000061f0| 6c 6f 79 65 65 2c 20 69 | 66 20 68 69 73 2f 68 65 |loyee, i|f his/he|
|00006200| 72 20 6d 65 64 69 63 61 | 6c 20 63 6f 6e 64 69 74 |r medica|l condit|
|00006210| 69 6f 6e 20 77 61 72 72 | 61 6e 74 73 2c 20 69 6e |ion warr|ants, in|
|00006220| 20 69 64 65 6e 74 69 66 | 79 69 6e 67 20 61 70 70 | identif|ying app|
|00006230| 72 6f 70 72 69 61 74 65 | 20 61 6e 64 20 72 65 61 |ropriate| and rea|
|00006240| 73 6f 6e 61 62 6c 65 20 | 61 63 63 6f 6d 6d 6f 64 |sonable |accommod|
|00006250| 61 74 69 6f 6e 73 2c 20 | 6f 72 20 63 6f 6e 63 65 |ations, |or conce|
|00006260| 72 6e 69 6e 67 20 76 61 | 63 61 6e 74 20 70 6f 73 |rning va|cant pos|
|00006270| 69 74 69 6f 6e 73 20 66 | 6f 72 20 77 68 69 63 68 |itions f|or which|
|00006280| 20 74 68 65 20 65 6d 70 | 6c 6f 79 65 65 20 6d 61 | the emp|loyee ma|
|00006290| 79 20 62 65 20 71 75 61 | 6c 69 66 69 65 64 20 61 |y be qua|lified a|
|000062a0| 66 74 65 72 20 72 65 61 | 73 6f 6e 61 62 6c 65 20 |fter rea|sonable |
|000062b0| 61 63 63 6f 6d 6d 6f 64 | 61 74 69 6f 6e 2e 0d 0d |accommod|ation...|
|000062c0| 31 30 2e 20 20 41 66 74 | 65 72 20 74 68 65 20 65 |10.  Aft|er the e|
|000062d0| 6d 70 6c 6f 79 65 65 20 | 72 65 74 75 72 6e 73 20 |mployee |returns |
|000062e0| 74 6f 20 77 6f 72 6b 2c | 20 74 68 65 20 65 6d 70 |to work,| the emp|
|000062f0| 6c 6f 79 65 65 20 73 68 | 6f 75 6c 64 20 61 64 76 |loyee sh|ould adv|
|00006300| 69 73 65 20 79 6f 75 20 | 6f 66 20 61 6e 79 20 64 |ise you |of any d|
|00006310| 6f 63 74 6f 72 d5 73 20 | 61 70 70 6f 69 6e 74 6d |octor.s |appointm|
|00006320| 65 6e 74 73 2e 20 20 49 | 74 20 69 73 20 41 70 70 |ents.  I|t is App|
|00006330| 6c 65 d5 73 20 70 72 61 | 63 74 69 63 65 20 74 68 |le.s pra|ctice th|
|00006340| 61 74 20 74 68 65 20 65 | 6d 70 6c 6f 79 65 65 20 |at the e|mployee |
|00006350| 77 69 6c 6c 20 72 65 63 | 65 69 76 65 20 66 75 6c |will rec|eive ful|
|00006360| 6c 20 73 61 6c 61 72 79 | 20 77 68 69 6c 65 20 61 |l salary| while a|
|00006370| 74 74 65 6e 64 69 6e 67 | 20 61 6e 79 20 64 6f 63 |ttending| any doc|
|00006380| 74 6f 72 20 61 70 70 6f | 69 6e 74 6d 65 6e 74 73 |tor appo|intments|
|00006390| 20 72 65 6c 61 74 65 64 | 20 74 6f 20 74 68 65 20 | related| to the |
|000063a0| 57 6f 72 6b 65 72 73 d5 | 20 43 6f 6d 70 65 6e 73 |Workers.| Compens|
|000063b0| 61 74 69 6f 6e 20 69 6e | 6a 75 72 79 20 63 6c 61 |ation in|jury cla|
|000063c0| 69 6d d1 69 74 20 69 73 | 20 6e 6f 74 20 6e 65 63 |im.it is| not nec|
|000063d0| 65 73 73 61 72 79 20 74 | 6f 20 75 73 65 20 70 65 |essary t|o use pe|
|000063e0| 72 73 6f 6e 61 6c 20 6f | 72 20 73 69 63 6b 20 74 |rsonal o|r sick t|
|000063f0| 69 6d 65 20 66 6f 72 20 | 74 68 65 73 65 20 76 69 |ime for |these vi|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.