Obtenga un formulario o publicación: occupational death

Su búsqueda de "occupational death" consiguió 10 resultados.

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Título	Tipo	Número
Claim for Pension By Dependents Also available in: Spanish Used by dependents of a deceased worker to file a claim for benefits.	Form	F242-062-000
Claim for Pension by Spouse or Children Also available in: Spanish Used by a spouse or dependents of a deceased worker. The workers' fatal accident or occupational disease incurred in the course of their employment. This application is needed to determine if applicant(s) is/are entitled to a survivor benefit.	Form	F242-056-000
Claim for Pension by Spouse or Children - Spanish Reclamo para Pensión de Esposo(a) o Los Niños Also available in: English Used by a spouse or dependents of a deceased worker. The workers' fatal accident or occupational disease incurred in the course of their employment. This application is needed to determine if applicant(s) is/are entitled to a survivor benefit.	Form	F242-056-999
Declaración De Derechos Para Dependiente Del Trabajador Fallecido Bajo El Programa De Compensación Y Beneficios Para Trabajadores Also available in: English Used by a dependent of a worker whose death was related to an on the job injury or accident. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of benefits.	Form	F242-173-933
Declaración De Derechos Para Padres O Tutor Bajo El Programa De Compensación Y Beneficios Para Trabajadores Also available in: English Used by a guardian or other person having custody of the minor or disabled children or dependents of a deceased worker to declare their entitlement to receive the pension benefits for those children/dependents in their care and custody.	Form	F242-173-922
Declaración De Derechos Para Viuda(O) Bajo El Programa De Compensación Y Beneficios Para Trabajadores Also available in: English Used by the widow/widower whose spouse died of a work related injury or accident. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of your benefits.	Form	F242-173-911
Declaration of Entitlement for Dependent of Deceased Worker Benefits Under Industrial Insurance Also available in: Spanish Used by a dependent of a worker whose death was related to an on the job injury or accident. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of benefits.	Form	F242-173-333
Declaration of Entitlement for Guardian Benefits under Industrial Insurance Also available in: Spanish Used by a guardian or other person having custody of the minor or disabled children or dependents of a deceased worker to declare their entitlement to receive the pension benefits for those children/dependents in their care and custody.	Form	F242-173-222
Declaration of Entitlement for Widow or Widower Benefits Under Industrial Insurance Also available in: Spanish Used by the widow/widower whose spouse died of a work related injury or accident. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of your benefits.	Form	F242-173-111
Reclamo for Pensión por Dependientes Also available in: English Used by dependents of a deceased worker to file a claim for benefits.	Form	F242-062-999
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