Active Members | Forms

Jury Duty Application Form

Coverage Details

Description

Replace lost wages in an event you missed work due to jury duty.

Applicable for

Member Only

Related Benefits

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Step 1

Download, print and fill out the form.

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Step 2

Upload the form using our online submission form.

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Submit by mail:

LiUNAcare Local 183
200 Labourers Way
Vaughan, ON, L4H 5H9
Suite 2100

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Jury Duty Application Form

Coverage Details

Submit your form online:

Submit by mail:

Get Mobile Access to Your Benefits

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Jury Duty Application Form

Coverage Details

Submit your form online:

Submit by mail:

Get Mobile Access to Your Benefits

Check Out Our Mobile Apps

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