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MERRILL'S INVESTIGATIONS & SECURITY SERVICES LLC
MICHAEL C. HARRINGTON SR.
PRIVATE INVESTIGATOR
POST OFFICE BOX 38
READFIELD, MAINE 04355
TELEPHONE #207-685-7309
FAX #207-685-7357

NEW ASSIGNMENT FORM:

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Social Security Number:

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Description of Claimant:

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Injury:

Date of Injury:

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