Employer's First Report of Injury, Illness or Death Forms
| Form Name | Employer's First Report of Injury, Illness or Death |
| Form # | Form 101 |
| Form Revision | Rev 4/2014 |
| Category | Forms » First Report |
| Downloads | |
| Form State | Massachusetts |
| Language | English |
| State Description | http://www.mass.gov/lwd/workers-compensation/forms/form-list-numbered/form-101.html |
| Claimwire Description | n/a |