Workers' Compensation - Forms (English)

Accident Investigation Report Form
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Accident Investigation.doc, 180.50 KB (Last Modified on October 31, 2012 )

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Election Form
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Election Form - Option 1 or 2 evised 2-08-13.pdf, 33.17 KB (Last Modified on February 19, 2013 )

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Employee Notice of Injury Report
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Employee Notice of Injury Report 2-28-2013.pdf, 129.85 KB (Last Modified on March 1, 2013 )

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Fraud Form
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Fraud_Form.doc, 21.50 KB (Last Modified on July 9, 2007 )

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Witness Statement
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Accident Witness Statement.doc, 165.50 KB (Last Modified on October 31, 2012 )

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Workers' Compensation - Forms (Spanish)