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 47 State Forms found

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EMPLOYEE CERTIFICATE OF COMPLIANCE

 LWC-WC-1025.EE REVISED 07/2008

Physician Choice Form: NOTICE TO INJURED WORKERS

 Form LWC – WC 1121 No Form/Rev Date

ANNUAL REPORT OF WORKERS' COMPENSATION COSTS

 LWC-WC-1000 REV. 01/10

APPLICATION FOR DIRECTORY OF SAFETY SERVICES

 No Form Number Undated Form

EMPLOYEE CERTIFICATE OF COMPLIANCE (Spanish)

 LDOL-WC 1025.EE Revisada 12/2000

LOUISIANA WORKFORCE COMMISSION OSHA CONSULTATION COST CONTAINMENT MEETING APPLICATION

 LWC-OWC #1021 (REVISED 01/09)

DISPUTED CLAIM FOR COMPENSATION

 LWC-WC-1008 REV. 4/14

DISPUTED CLAIM FOR MEDICAL TREATMENT

 LWC-WC 1009 Rev 12/2014

ELECTRONIC FUNDS TRANSFER ENROLLMENT FORM

 No Form Number No Form/Rev Date

EMPLOYEE'S QUARTERLY REPORT OF EARNINGS

 LWC-WC-1026 REVISED 7/08

EMPLOYEE’S MONTHLY REPORT OF EARNINGS

 LWC-WC 1020 REVISED 07/08/2008

EMPLOYER CERTIFICATE OF COMPLIANCE

 LWC-WC-1025.ER REV. 7/08

EMPLOYERS APPLICATION FOR THE PRIVILEGE OF PAYING COMPENSATION PROVIDED IN THE LOUISIANA WORKERS' COMPENSATION ACT AS SELF-INSURER

 LWC-WC-2005 No Form/Rev Date

INTERPRETER - ADA ACCOMODATIONS

 No Form Number Undated Form

IRREVOCABLE LETTER OF CREDIT

 No Form Number Undated Form
Disclaimer: These forms may not be the most recent version. Louisiana 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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