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

21 - 40 of 45 forms

Form Title Topics
Form SI-41 – Workers’ Compensation Premium Tax Report
Form SI-7-A – Loss Summary Data Report – Itemized Listing
Form SI-7 – Loss Summary Data Report
Forms Training Materials
Form TPA – Third-Party Administrator Application / Registration
GUARDIAN’S AFFIDAVIT - DEPENDENT CHILD(REN)
Hazard Survey Report
Health and Safety Plan Cover Sheet
HEALTH CARE NOTICE FOR EMPLOYEES UNDER MANAGED CARE
INSTRUCCIONES SOBRE LA COMPENSACIÓN DE LOS TRABAJADORES PARA EMPLEADORES Y EMPLEADOS
Medical Release
Mileage Reimbursement Worksheet
NOTICE OF CLAIMANT INFORMATION UPDATE / CHANGE OF ADDRESS
Notification of Potential Data Error
PHYSICIAN’S REPORT
RECLAMACIÓN DE COMPENSACIÓN
REPORT OF COMPENSATION PAID/SUSPENSION OF PAYMENTS
Self-Insurance Division
SOLICITUD PARA CERTIFICADO DE NO COBERTURA
SUPPLEMENTAL REPORT

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