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OTIP Health Claims Extended Health Benefits Claim PO Box …

OTIP Health Claims Extended Health Benefits Claim PO Box 280 Waterloo ON N2J 4A7 1.866.783.6847 | www.otip.com INSTRUCTIONS: (Please print all answers.) 1. All sections to be completed by the plan member unless otherwise indicated. 2. Original receipts must be attached for all expenses. (Please attach to the back of this form.) 3.

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  Health, Extended, Extended health

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