Notice of Potential Entitlement to Workers’ Compensation Death Benefits Forms
| Form Name | Notice of Potential Entitlement to Workers’ Compensation Death Benefits |
| Form # | PLN-12 |
| Form Revision | Rev. 12/23 |
| Category | Forms » Board/Commission/Division |
| Downloads | |
| Form State | Texas |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |