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Indiana Form Center


Welcome to the most extensive library of workers' compensation forms available anywhere. Almost 3,000 forms are available for your immediate download and use. Our forms, all of which have been custom programmed by WorkersCompensation.com for Type & Save functionality, are available for individual purchase below.

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(34401) First Report of Injury - 3/01
*** Must Be Sent Electronically to The Workers Compensation Board Of Indiana ***
(POSTENGL.doc) Worker's Compensation Notice - 11/04
(POSTSPAN.doc) Noticia de Compensacion Para Trabajadores - N/D
(01042) Application for Review by Full Board - 2/98
(01043) Agreement to Compensation - 5/96
(18487) Application for Adjustment of Claim for Provider Fee - 4/09
(18875) Agreement to Compensation Between the Dependants of Deceased Employee and Employer - 9/87
(29109) Application for Adjustment of Claim - 6/05
(36097) Notice For Workers' Compensation and Occupational Diseases Coverage - 3/09
(38911) Report to Claim Status/IME Request - 4/09
(45442) Request for Assistance - 5/06
(45899) Independant Contractor - Clearance Certificate Application - 7/06
(48557) Notice Of Inability To Determine Liability/Request For Additional Time - 9/97
(51247) Application for Second Injury Fund - 2/03
(53913) Employee Waiver of Examination By Personal Physician - 4/09
(53914) Notice of Denial of Benefits - 4/09
(si-1) Employer's Application For Permission To Carry Risk Without Insurance - 2006
(Guidelines) Workers' Compensation Self Insurance Renewal Applications - 2007
(si-2) Surety Bond - 2003
(si-3) Certificate of Excess Insurance - 2003
(si-4) Indemnity Agreement - 2003
(si-5) Employer's Request to Include a Subsidiary Within its Self-Insurance Program - 2003
(si-7) Trucker's Supplemental Application - 2003
(TPAApplication) Service Company Application For Permission To Serve Indiana Self-Insured Employers - N/D