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Arkansas Forms

62 State Forms found

name	number	revision	print or send online
NOTICE OF CLAIMANT INFORMATION UPDATE - CHANGE OF ADDRESS	Form SF-1	Rev. 1-1-2001
DEATH and PERMANENT TOTAL DISABILITY ACCEPTANCE/UPDATE	Form AR-D	Revised: 1-1-2001
EMPLOYER’S INTENT TO ACCEPT OR CONTROVERT CLAIM	Form AR-2	Revised 1-1-2013
Evaluation of Accident Prevention Services of Arkansas Workers' Compensation Insurance Carriers	Form HS-31-E	Rev. 1-1-2001
APPLICATION FOR GROUP SELF-INSURANCE	Form SI-11	Rev. 2/20/2024
GUARDIAN’S AFFIDAVIT - DEPENDENT CHILD(REN)	Form SF-5	Rev. 1-1-2001
Guardianship Affidavit (Court-Appointed, Non-Minor)	Form SF-2	Rev. 1-1-2001
Hazard Survey Report	Form HS-32-A	Rev. 1-1-2008
Health and Safety Plan Cover Sheet	Form HS-32-B	Rev. 1-1-2008
Health Care Notice for Employees Under Managed Care	Form AR-H	Revised 1-1-2001
INDIVIDUAL SELF-INSURER APPLICATION	Form SI-1	Rev. 2/20/2024
CLAIMANT’S LUMP SUM REQUEST/RESPONDENT’S POSITION	Form AR-L	Revised: 1-1-2001
Medical Mileage	No Form Numer	No Form/Rev Date
MONTHLY REPORT ON MEDICAL - ONLY INJURY DATA	Form AR-M	Revised: 1-1-2001
EMPLOYEE’S NOTICE OF INJURY (Spanish)	Formulario AR-N	Actualizada: 8-1-2006

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Disclaimer: These forms may not be the most recent version. Arkansas 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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