Form C1
Form C 1. Register for a new account. This report is required of every employing unit, and will be used to determine liability under.
Register for a new account. Web supervisor’s signature date signature of injured or disabled employee. To file a claim for compensation, see reverse. This report is required of every employing unit, and will be used to determine liability under.
Register for a new account. To file a claim for compensation, see reverse. Register for a new account. Web supervisor’s signature date signature of injured or disabled employee. This report is required of every employing unit, and will be used to determine liability under.
