Webform ia-1(r 1-1-02) see back for important information iaiabc 2002 . form ia-1(r 1-1-02) iaiabc 2002 employer’s instructions do not enter data in shaded fields dates: enter all dates in mm/dd/yy format. industry code: ... first report of injury or illness author: WebEMPLOYER'S REPORT OF WORK-RELATED INJURY/ILLNESS State of New York -Workers' Compensation Board C-2 C. EMPLOYEE'S PERSONAL INFORMATION 1. Name: 3. Mailing Address: 4. Social Security Number: 6. Gender: Male WCB Case Number (if you know it): If one of your employees has a work-related injury or illness, you must …
First Report of Injury or Illness - MyAttorneyHome.com
WebThe following forms need to be completed and submitted to EMPLOYERS when a work-related injury occurs: Employer’s Report of Work-Related Injury/Occupational Disease Form C-2F (First Report of Injury). As … WebThe standard Acord 130 application form for workers' comp coverage in New York. New York First Report of Injury Form. NY First Report of Injury Form. Employers should … easun reyrolle limited moneycontrol
NEW YORK STATE - DEPARTMENT OF LABOR INJURY …
WebThank you for your patience. There are presently two options for completing the Employer's First Report of Injury form and filing it with NH Department of Labor. Option One: Download the Adobe PDF version of the form , print it, complete it manually and either fax or mail it in. See the fax and mailing address below. Fax Number: (603) 271-0126. WebC-2F (1-14) Page 1 of 3 www.wcb.ny.gov WC9922a State of New York - Workers' Compensation Board Employer's First Report of Work-Related Injury/IllnessC-2F A … WebStep 1: The employee reports an injury to the employer Assess the condition of the injured worker. The employee should seek medical attention right away for a serious or life … eas uofa