Assignment of Account Agreement

Assignment of Account Agreement - (Forms/Publications)
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Title Assignment of Account Agreement (A fillable form - 78 KB PDF)
Description Used by a self-insured employer as an option to provide collateral for a total permanent disability claim.
Form number F207-058-000
Online only. See document above to download.
Keywords claims, disabled, permanent total disability, self insurance, self insurer, self-insurance, self-insurer, worker's compensation, workers compensation, workers' compensation
Languages English
Valid dates 12-2004
Contact information Self-Insurance
Web pages Self-Insured Employers

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