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103
![Form FI-41 "Vessel Owner (Employer) - Crewman Agreement Regarding Medical and Related Transportation or Other Expenses" - Alaska](https://data.templateroller.com/pdf_docs_html/111/1119/111939/form-fi-41-vessel-owner-employer-crewman-agreement-regarding-medical-and-related-transportation-or-other-expenses-alaska.png "Form FI-41 "Vessel Owner (Employer) - Crewman Agreement Regarding Medical and Related Transportation or Other Expenses" - Alaska")
![Form TQ01C "Alaska Quarterly Contribution Report" - Alaska, 2021](https://data.templateroller.com/pdf_docs_html/2121/21215/2121522/form-tq01c-alaska-quarterly-contribution-report-alaska.png "Form TQ01C "Alaska Quarterly Contribution Report" - Alaska, 2021")
![Form TQ01A "Alaska Quarterly Contribution Report Change Notification Sheet" - Alaska](https://data.templateroller.com/pdf_docs_html/2019/20192/2019279/form-tq01a-alaska-quarterly-contribution-report-change-notification-sheet-alaska.png "Form TQ01A "Alaska Quarterly Contribution Report Change Notification Sheet" - Alaska")
![Form TQ01C "Alaska Quarterly Contribution Report Wage Schedule Continuation Sheet" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767910/form-tq-01c-alaska-quarterly-contribution-report-wage-schedule-continuation-sheet-alaska.png "Form TQ01C "Alaska Quarterly Contribution Report Wage Schedule Continuation Sheet" - Alaska")
![Instructions for Form TQ01C "Alaska Quarterly Contribution Report" - Alaska](https://data.templateroller.com/pdf_docs_html/2121/21215/2121521/instructions-for-form-tq01c-alaska-quarterly-contribution-report-alaska.png "Instructions for Form TQ01C "Alaska Quarterly Contribution Report" - Alaska")
![Instructions for Form TQ01B, TQ01C "Alaska Quarterly Contribution Report" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767907/form-tq-01c-alaska-quarterly-contribution-report.png "Instructions for Form TQ01B, TQ01C "Alaska Quarterly Contribution Report" - Alaska")
![Form TADJ "Correction of Wage Items" - Alaska](https://data.templateroller.com/pdf_docs_html/2019/20192/2019284/form-tadj-correction-of-wage-items-alaska.png "Form TADJ "Correction of Wage Items" - Alaska")
![Form TSUP "Supplemental Alaska Quarterly Form" - Alaska](https://data.templateroller.com/pdf_docs_html/2008/20086/2008666/form-tsup-supplemental-alaska-quarterly-form-alaska.png "Form TSUP "Supplemental Alaska Quarterly Form" - Alaska")
![Form TREG "Alaska Employer Registration Form" - Alaska](https://data.templateroller.com/pdf_docs_html/2000/20005/2000540/form-treg-alaska-employer-registration-form-alaska.png "Form TREG "Alaska Employer Registration Form" - Alaska")
![Form TREG "Alaska Employer Registration Form" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767917/form-treg-alaska-employer-registration-form-alaska.png "Form TREG "Alaska Employer Registration Form" - Alaska")
![Form TREG "Voluntary Election of Coverage for Excluded Employment" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767928/form-treg-voluntary-election-coverage-excluded-employment-alaska.png "Form TREG "Voluntary Election of Coverage for Excluded Employment" - Alaska")
![Form 07-6119 "Fishermen's Fund Report of Vessel/Site Insurance" - Alaska](https://data.templateroller.com/pdf_docs_html/2019/20193/2019302/form-07-6119-fishermen-s-fund-report-of-vessel-site-insurance-alaska.png "Form 07-6119 "Fishermen's Fund Report of Vessel/Site Insurance" - Alaska")
![Form 07-1466 "Employee Application for Refund" - Alaska](https://data.templateroller.com/pdf_docs_html/2173/21732/2173277/form-07-1466-employee-application-for-refund-alaska.png "Form 07-1466 "Employee Application for Refund" - Alaska")
![Form 07-6153 "Reemployment, Election to Either Receive Reemployment Benefits or Waive Reemployment Benefits and Receive a Job Dislocation Benefit Instead" - Alaska](https://data.templateroller.com/pdf_docs_html/2000/20005/2000547/form-07-6153-reemployment-election-to-either-receive-reemployment-benefits-or-waive-reemployment-benefits-and-receive-a-job-dislocation-benefit-instead-alaska.png "Form 07-6153 "Reemployment, Election to Either Receive Reemployment Benefits or Waive Reemployment Benefits and Receive a Job Dislocation Benefit Instead" - Alaska")
![Form 07-6138 "Change of Address" - Alaska](https://data.templateroller.com/pdf_docs_html/2019/20193/2019301/form-07-6138-change-of-address-alaska.png "Form 07-6138 "Change of Address" - Alaska")
![Form 07-6130 "Renewal of Certificate of Self-insurance" - Alaska](https://data.templateroller.com/pdf_docs_html/2000/20005/2000548/form-07-6130-renewal-of-certificate-of-self-insurance-alaska.png "Form 07-6130 "Renewal of Certificate of Self-insurance" - Alaska")
![Form 07-6121 "Request for Release of Information" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767936/form-07-6121-request-release-information-alaska.png "Form 07-6121 "Request for Release of Information" - Alaska")
![Form 07-6131 "Petition for Executive Officer Waiver" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17672/1767256/form-07-6131-petition-executive-officer-waiver-alaska.png "Form 07-6131 "Petition for Executive Officer Waiver" - Alaska")
![Form 08-6106 "Claim for Workers' Compensation Benefits" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767934/form-08-6106-claim-workers-compensation-benefits-alaska.png "Form 08-6106 "Claim for Workers' Compensation Benefits" - Alaska")
![Form 07-6111 "Petition" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767933/form-07-6111-petition-alaska.png "Form 07-6111 "Petition" - Alaska")
![Form 07-6170 "Employer's Notice of 45 Consecutive Days of Time Loss for Injuries" - Alaska](https://data.templateroller.com/pdf_docs_html/1764/17641/1764188/form-07-6170-employer-s-notice-of-45-consecutive-days-of-time-loss-for-injuries-alaska.png "Form 07-6170 "Employer's Notice of 45 Consecutive Days of Time Loss for Injuries" - Alaska")
![Form 07-6169 "Employer's Notice of 90 Consecutive Days of Time Loss for Injuries" - Alaska](https://data.templateroller.com/pdf_docs_html/1764/17641/1764189/form-07-6169-employer-s-notice-of-90-consecutive-days-of-time-loss-for-injuries-alaska.png "Form 07-6169 "Employer's Notice of 90 Consecutive Days of Time Loss for Injuries" - Alaska")
![Form 07-6152 "Stipulation to Eligibility for Injuries" - Alaska](https://data.templateroller.com/pdf_docs_html/1764/17641/1764192/form-07-6152-stipulation-to-eligibility-for-injuries-alaska.png "Form 07-6152 "Stipulation to Eligibility for Injuries" - Alaska")
![Form 07-6166 "Application to Provide Reemployment Services as a Rehabilitation Specialist Under as 23.30.041" - Alaska](https://data.templateroller.com/pdf_docs_html/1764/17641/1764186/form-07-6166-application-to-provide-reemployment-services-as-a-rehabilitation-specialist-under-as-23-30-041-alaska.png "Form 07-6166 "Application to Provide Reemployment Services as a Rehabilitation Specialist Under as 23.30.041" - Alaska")
![Form 07-6124 "Commercial Fishermen's Fund Compelling Reasons Questionnaire" - Alaska](https://data.templateroller.com/pdf_docs_html/1764/17641/1764181/form-07-6124-commercial-fishermen-s-fund-compelling-reasons-questionnaire-alaska.png "Form 07-6124 "Commercial Fishermen's Fund Compelling Reasons Questionnaire" - Alaska")
Form 07-6124 "Commercial Fishermen's Fund Compelling Reasons Questionnaire" - Alaska
Size: 160 KB
4 pages
![Form 07-6058 "BI-Weekly Certified Payroll" - Alaska](https://data.templateroller.com/pdf_docs_html/1767/17679/1767948/form-07-6058-bi-weekly-certified-payroll-alaska.png "Form 07-6058 "BI-Weekly Certified Payroll" - Alaska")
![Form 07-6151 "Offer of Alternative Employment" - Alaska](https://data.templateroller.com/pdf_docs_html/147/1472/147210/form-07-6151-offer-alternative-employment-alaska.png "Form 07-6151 "Offer of Alternative Employment" - Alaska")
![Form 07-6171 "Reemployment Benefits Plan Checklist" - Alaska](https://data.templateroller.com/pdf_docs_html/1764/17641/1764191/form-07-6171-reemployment-benefits-plan-checklist-alaska.png "Form 07-6171 "Reemployment Benefits Plan Checklist" - Alaska")
![Form 07-6168 "Waiver of Reemployment Benefits" - Alaska](https://data.templateroller.com/pdf_docs_html/529/5297/529799/form-07-6168-waiver-of-reemployment-benefits-alaska.png "Form 07-6168 "Waiver of Reemployment Benefits" - Alaska")
![Form 07-6150 "Eligibility Evaluation Checklist" - Alaska](https://data.templateroller.com/pdf_docs_html/147/1472/147207/form-07-6150-eligibility-evaluation-checklist-alaska.png "Form 07-6150 "Eligibility Evaluation Checklist" - Alaska")
![Form 07-6110 "Notice of Possible Claim Against the Second Injury Fund" - Alaska](https://data.templateroller.com/pdf_docs_html/418/4189/418924/form-07-6110-notice-of-possible-claim-against-the-second-injury-fund-alaska.png "Form 07-6110 "Notice of Possible Claim Against the Second Injury Fund" - Alaska")
![Form 07-6103 "Workers' Compensation Medical Summary" - Alaska](https://data.templateroller.com/pdf_docs_html/1766/17665/1766564/form-07-6103-workers-compensation-medical-summary-alaska.png "Form 07-6103 "Workers' Compensation Medical Summary" - Alaska")
![Form 07-6120 "Employer's Notice of Insurance" - Alaska](https://data.templateroller.com/pdf_docs_html/1766/17665/1766571/form-07-6120-employer-s-notice-insurance-alaska.png "Form 07-6120 "Employer's Notice of Insurance" - Alaska")
![Form 07-6122 "Public Records Request" - Alaska](https://data.templateroller.com/pdf_docs_html/1766/17667/1766730/form-07-6122-public-records-request-alaska.png "Form 07-6122 "Public Records Request" - Alaska")
![Form 07-6135 "Request for Conference" - Alaska](https://data.templateroller.com/pdf_docs_html/123/1230/123050/form-07-6135-request-for-conference-alaska.png "Form 07-6135 "Request for Conference" - Alaska")
