Form Dwc-01 - Employer'S First Report Of Alleged Occupational Injury, Disease Or Fatality
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18State of Rhode Island
Department of Labor and Training
Division of Workers' Compensation
1511 Pontiac Avenue
Cranston, RI 02920
Forms Revised January, 2003
Form
Form
Number
Title
DWC-01
Employer's First Report of Alleged Occupational Injury or Disease
DWC-02
Memorandum of Agreement
DWC-03F
Wage Statement, Full Time
DWC-03P
Wage Statement, Part-Time
DWC-03S
Wage Statement, Seasonal
DWC-04
Employee's Certificate of Dependency Status
DWC-05
Suspension Agreement and Receipt
DWC-20
Non-Prejudicial Agreement
DWC-22
Report of Indemnity Payment
DWC-24
Mutual Agreement
DWC-25
Report of Earnings
DWC-30
Wage Transcript
DWC-31
Employee's Objection to Wage Transcript
DWC-32
Notice to Employees
DWC-50
Itemized Statement of Compensation
DWC-51
Report of Specific Payment
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Parent category: Business