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Louisiana Forms

17 State Forms found

name	number	revision	print or send online
ANNUAL REPORT OF WORKERS' COMPENSATION COSTS	LWC-WC-1000	REV. 01/10
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
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
IRREVOCABLE LETTER OF CREDIT	No Form Number	Undated Form
NOTICE OF PAYMENT, MODIFICATION, SUSPENSION, TERMINATION OR CONTROVERSION OF COMPENSATION OR MEDICAL BENEFITS	LWC-WC-1002	No Form/Rev Date
REQUEST FOR COMPROMISE OR LUMP SUM SETTLEMENT	LWC-WC-1011	REV. 07/08
REQUEST FOR SOCIAL SECURITY BENEFITS INFORMATION	LWC-WC-1004	REVISED 7/8/08
REQUEST FOR WAIVER OF PAYMENT OF ADVANCE COSTS FACTS CONCERNING THE EMPLOYEE	LWC-WC 1027	Revised 1/1/98
SECURITY AGREEMENT FOR CERTIFICATE OF DEPOSIT	No Form Number	Last Revised 7/08/08
SETTLEMENT EVALUATION	No Form Number	No Form/Rev Date
SETTLEMENT EVALUATION – PERMANENT & TOTAL	No Form Number	No Form/Rev Date
SPECIAL REIMBURSEMENT CONSIDERATION APPEAL	LWC-WC 3000	Undated Form

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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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