Case/Dispute arose where:
Case/Dispute arose where:
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Case/Dispute handed to other union/para-legal/legal representative?
Case/Dispute handed to other union/para-legal/legal representative?
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I confirm that that this form has been completed in full and serves a legal mandate to YNITU to handle my case. All information and supporting documents supplied have are a true record of the events and I further confirm I have authority to sign this form.
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Name of member signing mandate:
Name of member signing mandate:
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