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if any Answer all questions on both sides. Print clearly. Send to NYS Dept. of Labor State Office Campus Albany NY 12240 Taken by Section 198-c 3 of the New York State Labor Law excludes from wage supplement coverage those persons in an administrative executive or professional capacity whose earnings exceed 900 gross per week Note You must have asked for the supplements due before we can help you. 1. Your full name Ms. 2. Your address 3. Social Security number Mr. Apt. no. City town or village ...

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