Service Company Contact Update Forms
| Form Name | Service Company Contact Update |
| Form # | 440-5215 |
| Form Revision | 6/17 |
| Category | Forms » Board/Commission/Division |
| Downloads | |
| Form State | Oregon |
| Language | English |
| State Description | For use by insurers and self-insured employers to provide notification to the Workers' Compensation Division of a change in service company contact information. |
| Claimwire Description | n/a |