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235709

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This form is used for applying for the approval of licensing or certification tests in the state of Utah.

This form is used for applying for a cargo volume increase credit against employee withholding in South Carolina for port-related activities.

This form is used for applying for a hearing in Utah regarding an industrial accident claim.

This document is used for applying for approval of OJT (On-the-Job Training) or apprenticeship programs in the state of Utah.

This form is used for applying for a hearing to file an industrial accident claim in Utah. It provides instructions on how to proceed with your claim.

This Form is used for applying for hearing-dependent's benefits and/or burial benefits for an industrial accident claim in Utah.

This Form is used for applying for Hearing-Dependent's Benefits and/or Burial Benefits as part of an Occupational Disease Claim in the state of Utah.

This form is used for authorizing the disclosure, release, and use of protected health information for non-permanent total disability claims in Utah. It complies with HIPAA requirements and is specifically for maintaining records for a period of 10 years.

This Form is used for obtaining a list of medical treatment providers in Utah for official purposes.

This form is used for making changes to the ownership or name of an organization in the context of veterans' benefits in Utah.

This form is used for authorizing the disclosure, release, and use of protected health information for permanent total disability claims in Utah. It is HIPAA compliant and specifically pertains to a 15-year record period.

This form is used for authorizing the release of industrial accident division records in Utah.

This form is used for employers in Utah to report the first report of injury or illness that occurs in the workplace.

This form is used for excluding corporate officers in the state of Utah.

This form is used for reporting work injuries or occupational diseases in Utah.

This document is an Electronic Partnering Agreement specific to the state of Utah. It outlines the guidelines and requirements for electronic partnering with the Poc Iaiabc in Utah.

This document is an electronic trading partner profile for Utah. It is used for facilitating electronic transactions between business partners in the state of Utah.

This document is used for participating in the Iaiabc Electronic Partnering Agreement in Utah. It outlines the agreement terms and conditions for electronic partnering between parties.

This document is used for establishing electronic trading partnerships in Utah through the IAIABC system.

This document provides a list of electronic partnering insurer/claim administrator IDs in the state of Utah. It is used for identifying and interacting with insurers and claim administrators in electronic transactions related to workers' compensation.

This form is used for residents of Utah who want to change their doctors. It allows individuals to apply for a change of their primary care physician or specialist within the state.

This document outlines the electronic transmission profile for workers' compensation claims in Utah as per the standards set by the International Association of Industrial Accident Boards and Commissions (IAIABC).

This form is used for gathering information related to fair housing issues in Utah.

This form is used for assigning a wage claim in Utah, and it is available in both English and Spanish.

This document is for employers in Utah who need to obtain authorization to hire minors.

This document is used for notifying alleged violations of occupational safety and health in the workplace in Utah.

This Form is used for the endorsement of bankruptcy and insolvency proceedings in the state of Utah.

This Form is used for obtaining a self-insurance aggregate surety bond in the state of Utah.

This Form is used for an Agreement of Assumption and Guaranty of Workers' Compensation in the state of Utah. It outlines the responsibilities and obligations of parties involved in assuming and guaranteeing workers' compensation liabilities.

This form is used for applying for self-insurance in Utah. It is an official document that allows individuals or businesses to demonstrate their ability to cover potential losses or accidents without purchasing traditional insurance policies.

This document is a request to vary the requirements for boilers and pressure vessels in the state of Utah. It allows for exemptions or modifications to be made to the standard regulations.

This document is used for submitting a variance request for elevators or escalators in Utah. Users can seek permission for modifications or exemptions from the standard regulations.

This form is used for reporting confidential information on possible wrongdoing or misconduct in Utah.

This type of document is used to apply for a Certificate of Competency in Utah.

This Form is used for requesting an inspection of a new elevator in Utah.

This document is a cover sheet for a special design plan in Utah. It provides an overview of the plan and includes important information such as project details and contact information.

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