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IC Form MSC4 rev. 4/11 NORTH CAROLINA INDUSTRIAL COMMISSION N.C. Industrial Commission Mediation Section I. C. File No s. Carrier No* County 4342 Mail Service Center Raleigh NC 27699-4342 Plaintiff v* DESIGNATION OF MEDIATOR Defendant Carrier Appearances Plaintiff sAttorneyTelephone AddressFax Defendant s AttorneyTelephone THIS FORM IS TO BE COMPLETED BY EITHER THE PLAINTIFF OR THE DEFENDANT WITHIN THE TIME...
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