DEPARTMENT OF LABOR AND LICENSING

State of Arkansas

Official Website: https://www.labor.arkansas.gov/

Forms & Documents

Browse all DEPARTMENT OF LABOR AND LICENSING government forms

1 - 20 of 45 forms

Form Title Topics
ACCIDENT PREVENTION SERVICES ANNUAL REPORT
Accident Prevention Services Worksheet
APPLICATION FOR CERTIFICATE OF NON-COVERAGE
Application for (check all that apply)
APPLICATION FOR GROUP SELF-INSURANCE
AUTHORIZATION FOR RELEASE OF STUDENT INFORMATION
BEFORE THE ARKANSAS WORKERS’ COMPENSATION COMMISSION
CLAIM FOR COMPENSATION
COMISIÓN DE COMPENSACIÓN DE LOS TRABAJADORES DE ARKANSAS
Contact Designation Form for CLAIM OFFICE / MEDICAL BILLING / UNDERWRITER / ADMINISTRATOR
DEATH and PERMANENT TOTAL DISABILITY ACCEPTANCE/UPDATE
EMPLOYEE’S NOTICE OF INJURY
EMPLOYER’S INTENT TO ACCEPT OR CONTROVERT CLAIM
Evaluation of Accident Prevention Services of Arkansas Workers' Compensation Insurance Carriers
Form SF-2 – Guardianship Affidavit (Court – Appointed, Non-Minor)
Form SF-3 – Power of Attorney Notice & Affidavit
Form SF-4 – Surviving Spouse Notice & Affidavit
Form SF-6 – Affidavit for Dependents Other Than Spouse or Child
Form SF-7 – Certification of Acceptance
Form SI-12 – Application for Membership in a Group

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