855-1182
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BWC/ BWCEMPS/ BWCEMPSOSTC
|
OSC-4
|
Other States Coverage (OSC) Application Services Fee Documents
|
|
|
03/21/2018
|
|
855-1183
|
BWC/ BWCLAWS/ BWCLAWSFSIU
|
SVIU-01
|
SVIU Investigations
|
|
|
04/26/2018
|
|
855-1184
|
BWC/ BWCLAWS/ BWCLAWSLEGL
|
SIRP-01
|
Self-Insured Review Panel (SIRP) Files
|
|
|
04/26/2018
|
|
855-1185
|
BWC/ BWCHUMA/ BWCHUMAEEOO
|
HUMA-5
|
Exit Interview Questionnaire and Letter
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|
|
04/26/2018
|
|
855-1186
|
BWC/ BWCFDAD/ BWCFDADBPAY
|
BPAY-CCLB
|
Court Cost Litigation Bills
|
|
|
07/20/2023
|
|
855-1187
|
BWC/ BWCFDAD/ BWCFDAD
|
EMP-COMP1
|
Employer Compliance Tracker
|
|
|
08/13/2018
|
|
855-1188
|
BWC/ BWCFDAD/ BWCFDADMAIL
|
REAL1
|
Maintenance Service Records
|
|
|
08/30/2018
|
|
855-1189
|
BWC/ BWCEMPS/ BWCEMPSOSTC
|
OSC-3
|
Other States Coverage (OSC) Employer Premium Audit Documents
|
|
|
09/10/2018
|
|
855-1190
|
BWC/ BWCEMPS/ BWCEMPSOSTC
|
OSC-2
|
Other States Coverage (OSC) Employer Underwriting Documents
|
|
|
09/10/2018
|
|
855-1191
|
BWC/ BWCEMPS/ BWCEMPSOSTC
|
OSC-1
|
Other States Coverage (OSC) Employer Policy File
|
|
|
09/10/2018
|
|
855-1192
|
BWC/ BWCFDAD/ BWCFDADBPAY
|
BPAY-FX
|
Faxes
|
|
|
09/10/2018
|
|
855-1193
|
BWC/ BWCHUMA/ BWCHUMAPERS
|
HUMA-BC2
|
Drug Test Notification Form & results
|
|
|
09/20/2018
|
|
855-1194
|
BWC/ BWCHUMA/ BWCHUMAPERS
|
HUMA-BC1
|
Background Check Submission Forms and Results
|
|
|
09/20/2018
|
|
855-1195
|
BWC/ BWCFDAD/ BWCFDADREAL
|
FM-18
|
Facility Moves and Changes
|
|
|
12/06/2018
|
|
855-1196
|
BWC/ BWCFDAD/ BWCFDADARCC
|
ARCC-1
|
Warrant Pickup Signature List
|
|
|
11/19/2018
|
|
855-1197
|
BWC/ BWCLAWS/ BWCLAWSFSIU
|
SVIU-02
|
Actuarial Audit
|
|
|
11/23/2018
|
|
855-1198
|
BWC/ BWCHUMA/ BWCHUMA
|
HUMA-26
|
Public Employee Risk Reduction Program (PERRP) Report
|
|
|
12/06/2018
|
|
855-1199
|
BWC/ BWCHUMA/ BWCHUMA
|
HUMA-25
|
Internal Incident Reports
|
|
|
01/16/2019
|
|
855-1200
|
BWC/ BWCMIAD/ BWCMIADALLS
|
MIAD-66
|
IT Consultant Files
|
|
|
04/16/2019
|
|
855-1201
|
BWC/ BWCLAWS/ BWCLAWSRCDS
|
RCDS-6
|
Request for a Records Retention Schedule form Legal-26 & Records Inventory Worksheet form Legal-27
|
|
|
06/13/2019
|
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