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 154 State Forms found

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CORPORATE RESOLUTION AUTHORIZING APPLICATION TO THE DIRECTOR OF INDUSTRIAL RELATIONS, STATE OF CALIFORNIA FOR A CERTIFICATE OF CONSENT TO SELF-INSURE WORKERS’ COMPENSATION LIABILITIES

 Form S-3 (1-2016)

INDEMNITY AGREEMENT AND POWER OF ATTORNEY

 Form: S-4 (1-2016)

AGREEMENT OF ASSUMPTION AND GUARANTEE OF WORKERS’ COMPENSATION LIABILITIES FOR GROUP AND AFFILIATE MEMBERS

 Form: S-5 (1-2015)

AGREEMENT AND UNDERTAKING FOR SECURITY DEPOSIT

 Form: S-6 (1-2016)

Proposed Workers' Compensation Data Elements for Submission by California Self-Insured Public Entities and Self-Insurance Joint Powers Authorities

 No Form Number June 16, 2016

HOW TO REQUEST A QUALIFIED MEDICAL EVALUATOR IF YOU DO NOT HAVE AN ATTORNEY (Attachment to Form 105)

 No Form Number No Form/Rev Date

HOW TO REQUEST A QUALIFIED MEDICAL EVALUATOR In a represented case (Attachment to Form 106)

 No Form Number No Form/Revision Date

Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility - 勞工索賠表（勞工補償署表格 1）和潛在合格通知

 DWC 1 Rev. 1/1/2016

Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility - 근로자 산업재해 보상청구서(DWC 1) 및 잠재적 자격의 통지

 DWC 1 Rev. 1/1/2016

Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility Claim Form para sa Bayad-pinsala sa Mga Manggagawa (DWC 1) at Paunawa sa Posibleng Pagiging Karapat-dapat

DWC 1 Rev. 1/1/2016

Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility Mẫu Đơn Yêu Cầu Bồi Thường Bảo Hiểm Tai Nạn Lao Động (DWC 1) & Thông Báo về Khả Năng Đủ Điều Kiện

 DWC 1 Rev. 1/1/2016

Information & Assistance Unit guide 7 - How to file a petition for discrimination (Labor Code section 132a) - Packet

 I&A 7 Rev. 12/2023

Information & Assistance Unit guide 8 - How to file a serious & willful misconduct petition (Labor Code Section 4553) - Packet

 I&A 8 Rev. 12/2023

VERIFICATION - Serious and Willful Misconduct of Employer Pursuant to Labor Code Section 4553

 No Form Number April 2014

FEE DISCLOSURE STATEMENT (Spanish)

 Formulario DWC 3 (Rev. 1/17)
Disclaimer: These forms may not be the most recent version. California may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.
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