State Form 18875 Agreement to Compensation Between the Dependents of Deceased Employee and Employer - Indiana

State Form 18875 Agreement to Compensation Between the Dependents of Deceased Employee and Employer - Indiana

What Is State Form 18875?

This is a legal form that was released by the Indiana Workers' Compensation Board - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is State Form 18875?
A: State Form 18875 is an agreement to compensation between the dependents of a deceased employee and the employer.

Q: Who does State Form 18875 apply to?
A: State Form 18875 applies to the dependents of a deceased employee and the employer.

Q: What does State Form 18875 include?
A: State Form 18875 includes the agreement to compensation between the dependents of a deceased employee and the employer.

Q: What is the purpose of State Form 18875?
A: The purpose of State Form 18875 is to establish the compensation agreement between the dependents of a deceased employee and the employer.

ADVERTISEMENT

Form Details:

  • Released on May 1, 2010;
  • The latest edition provided by the Indiana Workers' Compensation Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of State Form 18875 by clicking the link below or browse more documents and templates provided by the Indiana Workers' Compensation Board.

Download State Form 18875 Agreement to Compensation Between the Dependents of Deceased Employee and Employer - Indiana

4.6 of 5 (17 votes)
  • State Form 18875 Agreement to Compensation Between the Dependents of Deceased Employee and Employer - Indiana, Page 1
ADVERTISEMENT