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Me. UC-28 (rev. 09/2013)
MAINE DEPARTMENT OF LABOR
Bureau of Unemployment Compensation
47 State House Station
Augusta ME 04333-0047
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That UI Account No.
having its principal office at Federal ID No.
(Business mailing address)
(City) (State) (Zip Code)
hereby constitutes and appoints ___________________________________________________________
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