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Vermont Department of Labor Forms

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DOL Form C-1 Business Registration - Vermont PDF

DOL Form C-1 Business Registration - Vermont
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DOL Form 2 Denial of Workers' Compensation Benefits by Employer or Carrier - Vermont PDF

DOL Form 2 Denial of Workers' Compensation Benefits by Employer or Carrier - Vermont
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Form 7 Vermont Workers' Compensation Medical Authorization - Vermont PDF

Form 7 Vermont Workers' Compensation Medical Authorization - Vermont
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Form VR8 Notice of Intent to Change Vocational Rehabilitation Provider - Vermont PDF

Form VR8 Notice of Intent to Change Vocational Rehabilitation Provider - Vermont
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Form HCP1 Health Care Provider Report - Vermont PDF

Form HCP1 Health Care Provider Report - Vermont
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DOL Form 1 Employer First Report of Injury - Vermont PDF

DOL Form 1 Employer First Report of Injury - Vermont
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DOL Form 4 Report of Fatal Accident - Vermont PDF

DOL Form 4 Report of Fatal Accident - Vermont
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DOL Form 5 Employee's Notice of Injury and Claim for Compensation - Vermont PDF

DOL Form 5 Employee's Notice of Injury and Claim for Compensation - Vermont
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DOL Form 6 Notice and Application for Hearing - Vermont PDF

DOL Form 6 Notice and Application for Hearing - Vermont
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DOL Form 8 Notice of Intent to Change Health Care Provider - Vermont PDF

DOL Form 8 Notice of Intent to Change Health Care Provider - Vermont
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DOL Form B-1 Return to Work Notification - Vermont PDF

DOL Form B-1 Return to Work Notification - Vermont
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DOL Form EL-1 Employee Leasing Company Licensure & Registration Application - Vermont PDF

DOL Form EL-1 Employee Leasing Company Licensure & Registration Application - Vermont
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DOL Form EL-2 Authorizing Individual Affidavit - Vermont PDF

DOL Form EL-2 Authorizing Individual Affidavit - Vermont
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DOL Form EL-3 Surety Bond - Vermont PDF

DOL Form EL-3 Surety Bond - Vermont
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DOL Form EL-6 List of Vermont Clients - Vermont PDF

DOL Form EL-6 List of Vermont Clients - Vermont
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Form B-2 Claimant Change of Address Form - Vermont PDF

Form B-2 Claimant Change of Address Form - Vermont
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DOL Form 28 Notice of Change in Compensation Rate (For Injuries After July 1, 1986) - Vermont, 2023 PDF

DOL Form 28 Notice of Change in Compensation Rate (For Injuries After July 1, 1986) - Vermont, 2023
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DOL Form 28 Notice of Change in Compensation Rate (For Injuries After July 1, 1986) - Vermont, 2022 PDF

DOL Form 28 Notice of Change in Compensation Rate (For Injuries After July 1, 1986) - Vermont, 2022
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Form WH-11 Minimum Wage Rate - Vermont PDF

Form WH-11 Minimum Wage Rate - Vermont
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Form WH-27 Child Labor Certificate - Vermont PDF

Form WH-27 Child Labor Certificate - Vermont
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DOL Form 27 Employer's Notice of Intention to Discontinue Payments - Vermont PDF

DOL Form 27 Employer's Notice of Intention to Discontinue Payments - Vermont
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DOL Form 32 Agreement for Temporary Compensation - Vermont PDF

DOL Form 32 Agreement for Temporary Compensation - Vermont
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Form C-45 Penalty Waiver Request Form for Vermont Unemployment Insurance Wage Reporting - Vermont PDF

Form C-45 Penalty Waiver Request Form for Vermont Unemployment Insurance Wage Reporting - Vermont
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DOL Form C-49 Memorandum of Understanding - for 3rd Party Reporter - Vermont PDF

DOL Form C-49 Memorandum of Understanding - for 3rd Party Reporter - Vermont
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DOL Form B-82 Work Search Report - Vermont PDF

DOL Form B-82 Work Search Report - Vermont
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Form WH-11 Minimum Wage Rate - Vermont PDF

Form WH-11 Minimum Wage Rate - Vermont
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Form B-82 Work Search Log - Vermont PDF

Form B-82 Work Search Log - Vermont
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DOL Form 16 Compromise Agreement - Vermont PDF

DOL Form 16 Compromise Agreement - Vermont
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DOL Form C-61 New Hire Reporting Form - Vermont PDF

DOL Form C-61 New Hire Reporting Form - Vermont
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DOL Form 10 Certificate of Dependency and Concurrent Employment - Vermont PDF

DOL Form 10 Certificate of Dependency and Concurrent Employment - Vermont
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DOL Form B-37 Promise of Full-Time Employment - Vermont PDF

DOL Form B-37 Promise of Full-Time Employment - Vermont
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DOL Form 20 Work Capabilities Form - Vermont PDF

DOL Form 20 Work Capabilities Form - Vermont
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DOL Form 22 Agreement for Permanent Partial or Permanent Total Disability Compensation - Vermont PDF

DOL Form 22 Agreement for Permanent Partial or Permanent Total Disability Compensation - Vermont
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DOL Form 23 Agreement for Compensation in Fatal Cases - Vermont PDF

DOL Form 23 Agreement for Compensation in Fatal Cases - Vermont
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DOL Form 25 Wage Statement - Vermont PDF

DOL Form 25 Wage Statement - Vermont
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DOL Form 13 Report of Benefits and Related Expenses Paid - Vermont PDF

DOL Form 13 Report of Benefits and Related Expenses Paid - Vermont
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DOL Form F-35 Refusal of "suitable Work" - Fact Finding Form - Vermont PDF

DOL Form F-35 Refusal of "suitable Work" - Fact Finding Form - Vermont
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DOL Form B-65 Application for Unemployment Insurance - Vermont PDF

DOL Form B-65 Application for Unemployment Insurance - Vermont
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DOL Form B-12 Ui Claimant Appeal Form - Vermont PDF

DOL Form B-12 Ui Claimant Appeal Form - Vermont
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Form D-11 Properly Report Gross Wages - Vermont PDF

Form D-11 Properly Report Gross Wages - Vermont
Vermont Unemployment Claim Forms Unemployment Claim Form Welfare Benefits Vermont Legal Forms Legal United States Legal Forms
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