PDF
Word
Form CCA-0004A Accident, Illness or Injury Report - Arizona (English / Spanish)
What Is Form CCA-0004A?
This is a legal form that was released by the Arizona Department of Economic Security - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form CCA-0004A?A: Form CCA-0004A is the Accident, Illness or Injury Report specifically for Arizona, available in both English and Spanish.
Q: What is the purpose of Form CCA-0004A?A: The purpose of Form CCA-0004A is to report accidents, illnesses, or injuries that occur in Arizona.
Q: Is Form CCA-0004A available in Spanish?A: Yes, Form CCA-0004A is available in both English and Spanish.
Q: Who should fill out Form CCA-0004A?A: Form CCA-0004A should be filled out by anyone who needs to report an accident, illness, or injury that occurred in Arizona.
Form Details:
- Released on December 1, 2022;
- The latest edition provided by the Arizona Department of Economic Security;
- 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 fillable version of Form CCA-0004A by clicking the link below or browse more documents and templates provided by the Arizona Department of Economic Security.
Download Form CCA-0004A Accident, Illness or Injury Report - Arizona (English / Spanish)
1
2
