Delaware Department of Labor Forms
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Form UC-1 "Report to Determine Liability and if Liable Application for Employer Account Number" - Delaware
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Form DVR-1 "Referral for Services" - Delaware
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Form UC-8 "Employer's Quarterly Report Forms" - Delaware
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Form 18 "Agreement for Compensation for Death" - Delaware
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Form UC-400 "Application for Rehire Credit" - Delaware
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Form UC-114 "Low Earnings Report" - Delaware
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30 KB
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Form COM-4069 "Nonprofit Organizations Certificate of Election of Reimbursement of Benefits Paid in Lieu of Required Assessments" - Delaware
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"Request for Visor Communication Card Form" - Delaware
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"Referral for Services" - Delaware
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"Dvr Job Placement - Coaching and Supported Employment Progress Report Form" - Delaware
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"Agreement as to Compensation Paid" - Delaware
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"Eligibility Certification Form" - Delaware
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"Petition to Determine Compensation Due to Injured Employee" - Delaware
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67 votes
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"Petition to Determine Compensation Due to Dependents of Deceased Employee" - Delaware
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69 votes
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"Pre-trial Memorandum" - Delaware
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51 votes
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101 KB
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"Educational/Training Support Services Progress Report Form" - Delaware
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56 votes
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"Customized Employment Assessment Form" - Delaware
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55 votes
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"Consumer Placement, Job Coaching and Supported Employment Agreement Form" - Delaware
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"Applied Behavioral Support Services Assessment Form" - Delaware
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54 votes
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"Denial of Community Rehabilitation Services Form" - Delaware
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"Employment Readiness Training Agreement Form" - Delaware
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"Assistive Technology and Accommodation(S) Assessment Form" - Delaware
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82 votes
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285 KB
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"Community Based Work Assessment Form" - Delaware
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"Monthly Progress Report Form - Employment Readiness Training" - Delaware
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"Petition to Determine Additional Compensation Due to Injured Employee" - Delaware
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"Petition for Commutation" - Delaware
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"Petition to Review Compensation Agreement" - Delaware
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"Petition to Appeal a Utilization Review" - Delaware
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"Adjustment Application" - Delaware
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"Petition to Determine Disfigurement" - Delaware
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"First Report of Occupational Injury or Disease" - Delaware
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"Power of Attorney" - Delaware
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"Receipt of Compensation Paid" - Delaware
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![Form UC-1 "Report to Determine Liability and if Liable Application for Employer Account Number" - Delaware](https://data.templateroller.com/pdf_docs_html/1889/18893/1889363/form-uc-1-report-to-determine-liability-and-if-liable-application-employer-account-number-delaware.png "Form UC-1 "Report to Determine Liability and if Liable Application for Employer Account Number" - Delaware")
![Form DVR-1 "Referral for Services" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783215/form-dvr-1-referral-services-delaware.png "Form DVR-1 "Referral for Services" - Delaware")
![Form UC-8 "Employer's Quarterly Report Forms" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783228/form-uc-8-employer-s-quarterly-report-forms-delaware.png "Form UC-8 "Employer's Quarterly Report Forms" - Delaware")
![Form 18 "Agreement for Compensation for Death" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17641/1764196/form-18-agreement-for-compensation-for-death-delaware.png "Form 18 "Agreement for Compensation for Death" - Delaware")
![Form UC-400 "Application for Rehire Credit" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17643/1764306/form-uc-400-application-for-rehire-credit-delaware.png "Form UC-400 "Application for Rehire Credit" - Delaware")
![Form UC-114 "Low Earnings Report" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17642/1764299/form-uc-114-low-earnings-report-delaware.png "Form UC-114 "Low Earnings Report" - Delaware")
![Form COM-4069 "Nonprofit Organizations Certificate of Election of Reimbursement of Benefits Paid in Lieu of Required Assessments" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17643/1764303/form-com-4069-nonprofit-organizations-certificate-of-election-of-reimbursement-of-benefits-paid-in-lieu-of-required-assessments-delaware.png "Form COM-4069 "Nonprofit Organizations Certificate of Election of Reimbursement of Benefits Paid in Lieu of Required Assessments" - Delaware")
!["Request for Visor Communication Card Form" - Delaware](https://data.templateroller.com/pdf_docs_html/2239/22391/2239154/request-for-visor-communication-card-form-delaware.png ""Request for Visor Communication Card Form" - Delaware")
!["Referral for Services" - Delaware](https://data.templateroller.com/pdf_docs_html/2001/20010/2001005/referral-for-services-delaware.png ""Referral for Services" - Delaware")
!["Dvr Job Placement - Coaching and Supported Employment Progress Report Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783225/dvr-job-placement-coaching-and-supported-employment-progress-report-form-delaware.png ""Dvr Job Placement - Coaching and Supported Employment Progress Report Form" - Delaware")
!["Agreement as to Compensation Paid" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17641/1764195/agreement-as-to-compensation-paid-delaware.png ""Agreement as to Compensation Paid" - Delaware")
!["Eligibility Certification Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783207/eligibility-certification-form-delaware.png ""Eligibility Certification Form" - Delaware")
!["Petition to Determine Compensation Due to Injured Employee" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783210/petition-to-determine-compensation-due-to-injured-employee-delaware.png ""Petition to Determine Compensation Due to Injured Employee" - Delaware")
!["Petition to Determine Compensation Due to Dependents of Deceased Employee" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783212/petition-to-determine-compensation-due-to-dependents-deceased-employee-delaware.png ""Petition to Determine Compensation Due to Dependents of Deceased Employee" - Delaware")
!["Pre-trial Memorandum" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783214/pre-trial-memorandum-delaware.png ""Pre-trial Memorandum" - Delaware")
!["Educational/Training Support Services Progress Report Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783217/educational-training-support-services-progress-report-form-delaware.png ""Educational/Training Support Services Progress Report Form" - Delaware")
!["Customized Employment Assessment Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783218/customized-employment-assessment-form-delaware.png ""Customized Employment Assessment Form" - Delaware")
!["Consumer Placement, Job Coaching and Supported Employment Agreement Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783219/consumer-placement-job-coaching-and-supported-employment-agreement-form-delaware.png ""Consumer Placement, Job Coaching and Supported Employment Agreement Form" - Delaware")
!["Applied Behavioral Support Services Assessment Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783220/applied-behavioral-support-services-assessment-form-delaware.png ""Applied Behavioral Support Services Assessment Form" - Delaware")
!["Denial of Community Rehabilitation Services Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783221/denial-community-rehabilitation-services-form-delaware.png ""Denial of Community Rehabilitation Services Form" - Delaware")
!["Employment Readiness Training Agreement Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783222/employment-readiness-training-agreement-form-delaware.png ""Employment Readiness Training Agreement Form" - Delaware")
!["Assistive Technology and Accommodation(S) Assessment Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783223/assistive-technology-and-accommodation-s-assessment-form-delaware.png ""Assistive Technology and Accommodation(S) Assessment Form" - Delaware")
!["Community Based Work Assessment Form" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783224/community-based-work-assessment-form-delaware.png ""Community Based Work Assessment Form" - Delaware")
!["Monthly Progress Report Form - Employment Readiness Training" - Delaware](https://data.templateroller.com/pdf_docs_html/1783/17832/1783227/monthly-progress-report-form-employment-readiness-training-delaware.png ""Monthly Progress Report Form - Employment Readiness Training" - Delaware")
!["Petition to Determine Additional Compensation Due to Injured Employee" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17641/1764198/petition-to-determine-additional-compensation-due-to-injured-employee-delaware.png ""Petition to Determine Additional Compensation Due to Injured Employee" - Delaware")
!["Petition for Commutation" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17641/1764197/petition-for-commutation-delaware.png ""Petition for Commutation" - Delaware")
!["Petition to Review Compensation Agreement" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17642/1764201/petition-to-review-compensation-agreement-delaware.png ""Petition to Review Compensation Agreement" - Delaware")
!["Petition to Appeal a Utilization Review" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17641/1764199/petition-to-appeal-a-utilization-review-delaware.png ""Petition to Appeal a Utilization Review" - Delaware")
!["Adjustment Application" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17643/1764301/adjustment-application-form-delaware.png ""Adjustment Application" - Delaware")
!["Petition to Determine Disfigurement" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17642/1764200/petition-to-determine-disfigurement-delaware.png ""Petition to Determine Disfigurement" - Delaware")
!["First Report of Occupational Injury or Disease" - Delaware](https://data.templateroller.com/pdf_docs_html/304/3046/304615/first-report-of-occupational-injury-or-disease-delaware.png ""First Report of Occupational Injury or Disease" - Delaware")
!["Power of Attorney" - Delaware](https://data.templateroller.com/pdf_docs_html/1764/17643/1764304/power-of-attorney-delaware.png ""Power of Attorney" - Delaware")
!["Receipt of Compensation Paid" - Delaware](https://data.templateroller.com/pdf_docs_html/234/2349/234936/receipt-of-compensation-paid-delaware.png ""Receipt of Compensation Paid" - Delaware")