Industrial Commission Forms and Office Locations – Government Agency in North Carolina

21 - 40 of 73 forms

Form Title	Topics
Form 28, Return To Work Report
Form 28T, Notice of Termination of Compensation by Reason of Trial Return to Work
Form 28U, Employee's Request That Compensation Be Reinstated After Unsuccessful Trial Return to Work
Form 29, Supplemental Report to Form 19 for Fatal Accidents
Form 30, Agreement for Compensation for Death
Form 30A, Notice of Award
Form 30D, Award Approving Agreement for Compensation for Death
Form 31, Application for Lump Sum Award
Form 33I, Intervenor's Request That Claim be Assigned for Hearing
Form 33, Request That Claim Be Assigned for Hearing (Spanish Form 33)
Form 33R, Response to Request That Claim Be Assigned for Hearing
Form 36, Subpoena for Witness
Form 42, Application for Appointment of Guardian Ad Litem
Form 44, Application for Review
Form 51, Annual Consolidated Fiscal Report of "Medical Only" or "Lost Time" Cases
Form 51, Instructions
Form 60, Employer's Admission of Employee's Right to Compensation
Form 61, Denial of Workers' Compensation Claim
Form 62, Notice of Reinstatement or Modification of Compensation
Form 63, Notice to Employee of Payment of Compensation Without Prejudice or Payment of Medical Compensation Without Prejudice

Industrial Commission