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 23 State Forms found

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AVERAGE WEEKLY WAGE WORKSHEET

DK 1 Rev 05/06

Dependent's Notice and Claim for Compensation

 WC18 08/22

FINAL ADMISSION OF LIABILITY

 WC4 Rev 03/19

PETITION TO MODIFY, TERMINATE, OR SUSPEND COMPENSATION / OBJECTION TO PETITION TO MODIFY, TERMINATE, OR SUSPEND COMPENSATION

 WC54 Rev 07/21

Payroll Statement Form for the period beginning January 1, 2020 and ending June 30, 2020

 WC112 Rev 06/20

REQUEST FOR LUMP SUM PAYMENT (Permanent Partial, Permanent Total and Dependents’ Benefits)

 WC62 Rev. 07/14

DIVISION OF WORKERS’ COMPENSATION SETTLEMENT ROUTING SHEET

 WC105 Rev 03/14

Surcharge Form for the period beginning July 1, 2017 and ending December 31, 2017

 WC113 Rev 11/17

Medical Dispute Resolution Intake Form

 WC 181 Rev 10/24

PAYROLL STATEMENT FORM for the period beginning January 1, 2018 and ending June 30, 2018

 WC112 Rev 05/18

Payroll Statement Form for the period beginning July 1, 2018 and ending December 31, 2018

WC112 Rev 12/18

Payroll Statement Form for the period beginning January 1, 2019 and ending June 30, 2019

 WC112 Rev 06/19

Surcharge Form for the period beginning January 1, 2019 and ending June 30, 2019

 WC113 Rev 06/19

Application to the Colorado Uninsured Employer Fund

 WC202 Rev 09/23

Surcharge Form for the period beginning July 1, 2020 and ending December 31, 2020

 WC 113 Rev 12/20
Disclaimer: These forms may not be the most recent version. Colorado 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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