Long Beach California Notification of Workers' Compensation Injury - Illness

State:
Multi-State
City:
Long Beach
Control #:
US-294EM
Format:
Word; 
Rich Text
Instant download
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Public form

Description

This form is used to inform a worker's compensation firm of an injury or illness of sustained by an employee while on duty.

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Long Beach California Notification of Workers' Compensation Injury - Illness