APPLICATION FOR LUMP SUM PAYMENT Forms
| Form Name | APPLICATION FOR LUMP SUM PAYMENT |
| Form # | MWCC Form B-19 |
| Form Revision | (Revised 1/2003) |
| Category | Forms » Financial/Compensation |
| Downloads | |
| Form State | Mississippi |
| Language | English |
| State Description | This form is filed by the claimant to request a lump sum payment in accordance with the provisions of Mississippi Code Annotated Section 71-3-37 (10) (1972). (General Rule 13; Procedural Rule 15) |
| Claimwire Description | n/a |