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This version of the form is not currently in use and is provided for reference only. Download this version of
Form D-21
for the current year.
Form D-21 Fatality Report - Nevada
What Is Form D-21?
This is a legal form that was released by the Nevada Department of Business and Industry - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form D-21?A: Form D-21 is a Fatality Report form used in Nevada.
Q: When is Form D-21 used?A: Form D-21 is used when reporting a fatality in Nevada.
Q: Who should complete Form D-21?A: Form D-21 should be completed by the person responsible for reporting the fatality.
Q: Is Form D-21 specific to a certain industry?A: No, Form D-21 can be used to report fatalities in any industry in Nevada.
Q: What information is required on Form D-21?A: Form D-21 requires information about the deceased person, the incident, and the employer.
Q: Are there any deadlines for submitting Form D-21?A: Yes, Form D-21 must be submitted within 8 hours of the fatality.
Q: Is Form D-21 confidential?A: No, Form D-21 is considered a public record and may be subject to disclosure.
Q: Are there any fees associated with submitting Form D-21?A: No, there are no fees for submitting Form D-21.
Form Details:
- Released on June 1, 2018;
- The latest edition provided by the Nevada Department of Business and Industry;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form D-21 by clicking the link below or browse more documents and templates provided by the Nevada Department of Business and Industry.
