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Rhode Island Forms

61 State Forms found

name	number	revision	print or send online
SELF-INSURANCE AGREEMENT	RI SI-17	No Form/Rev Date
NOTICE TO EMPLOYEES REGARDING THE EFFECT OF ENDORSEMENT OF BENEFIT CHECK (Spanish)	DWC-32S	(01/2021)
Agreement For Electronic Payment of Workers' Compensation Benefits	DWC-EB1	(Rev. 01/2021)
Rescission of Agreement for Electronic Payment of Workers' Compensation Benefits	DWC-EB2	(Rev. 01/2021)
(DISCONTINUED BY STATE) - State of Rhode Island Licensed Insurers Assessment Return Fund	No form number DEACTIVATED	No date
RENEWAL APPLICATION FOR APPROVAL OF WORKERS’ COMPENSATION SELF-INSURANCE PROGRAM	RI SI-2a	(March 2012)
BOND OF EMPLOYER AUTHORIZED TO PAY WORKERS’ COMPENSATION BENEFITS DIRECTLY TO EMPLOYEES OR THEIR DEPENDENTS	RI SI-5	No Form/Rev Date
SURETY BOND EXTENSION AGREEMENT	RI SI-5a	(March 1, 2012)
BOND OF EMPLOYER AUTHORIZED TO PAY WORKERS’ COMPENSATION BENEFITS DIRECTLY TO EMPLOYEES OR THEIR DEPENDENTS	RI SI-5c	No Form/Rev Date
STANDBY LETTER OF CREDIT	RI SI-6	No Form/Rev Date
ESCROW AGREEMENT	RI SI 7	No Form/Rev Date
TRUST AGREEMENT	RI SI-7a	No Form/Rev Date
Certificate of Deposit Agreement	RI SI-7b	No Form/Rev Date
CERTIFICATE	RI SI-9	No Form/Rev Date
CERTIFICATE	RI SI-9a	No Form/Rev Date

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Disclaimer: These forms may not be the most recent version. Rhode Island 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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