Industrial Insurance Discrimination Complaint
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
||
| Title |
Industrial Insurance Discrimination Complaint (A fillable form - 142 KB PDF)
|
|
| Description | Employees who believe they have been discriminated against by their employer use this form to file a complaint. | |
| Detail | ||
| Form number | F262-009-000 | |
| Availability | Online only. See document above to download. |
|
| Keywords | discrimination, employer, Retaliation, worker | |
| Languages | English , Spanish | |
| Valid dates | 05-2012 | |
| Contact information |
Workers' Comp Fraud Investigation
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|
| Web pages | Fraud & Complaints | |
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