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 17 State Forms found

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NOTICE OF CLAIM STATUS

IC Form 8 No Form/Rev Date

COMPLAINT AGAINST THE INDUSTRIAL SPECIAL INDEMNITY FUND (ISIF)

 IC1002 Rev. May 8, 2013

DECLARATION UNDER IDAHO CODE § 72-212(5)

 Form IC53 Revised 03/22/22

Primary Claims Adjuster Assignment Form

 No Form Number Revised 7/19

NOTICE OF INTENT TO FILE A WORKERS’ COMPENSATION COMPLAINT AGAINST THE INDUSTRIAL SPECIAL INDEMNITY FUND

ISIF revised form 1/25/2008

Contact Form

 No Form Number No Form/Rev Date

Referral Form

 No Form Number No Form/Rev Date

SEMI-ANNUAL REPORT WORKERS' COMPENSATION PREMIUM TAX

IC 4008 Revised 07/2024

WORKERS' COMPENSATION COMPLAINT

 IC1001 No Form/Rev Date

CONSENT OF THE BOARD OF DIRECTORS

 No Form Number No Form/Rev Date

REQUEST FOR WORKERS’ COMPENSATION RECORDS BY PARTIES

 I.C. Records Form RMR-1 Revised: September 1, 2019

CLAIMANT’S REQUEST FOR PERSONAL WORKERS’ COMPENSATION RECORDS

 I.C. Records Form RMR-4 Revised: September 1, 2019

REQUEST FOR MICROFILMED WORKERS’ COMPENSATION RECORDS BY PARTIES

 I.C. Records Form RMR-6 Revised: January 1, 2019

EMPLOYER CERTIFICATE AND REQUEST FOR CLAIMS HISTORY

 I.C. Records Form RMR-2 Revised: September 1, 2019

EMPLOYER CERTIFICATE AND CLAIMS HISTORY RELEASE

 I.C. Records Form RMR-3 Revised: September 1, 2019
Disclaimer: These forms may not be the most recent version. Idaho 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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