Forms

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101 - 120 of 167 results
Form name Agencies Form files Details
OWCP LS-275ic: Agreement and Undertaking (Insurance Carrier) OWCP
OWCP LS-275si: Agreement and Undertaking (Self-Insured Employer) OWCP
OWCP LS-276: Application for Security Deposit Determination OWCP
OWCP LS-33: Approval of Compromise of Third Person Cause of Action OWCP
OWCP LS-4: Attorney Fee Approval Request OWCP
OWCP LS-426: Request for Earnings Information OWCP
OWCP LS-5: Application for Special Fund Relief OWCP
OWCP LS-513: Report of Payments OWCP
OWCP LS-570: Carrier's Report of Issuance of Policy OWCP
OWCP LS-6: Commutation Application OWCP
OWCP LS-7: Request for Intervention OWCP
OWCP LS-8: Settlement Approval Request Section 8(i) OWCP
OWCP LS-801: Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers OWCP
OWCP LS-802: Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives OWCP
OWCP LS-9: Stipulation Approval Request OWCP
OWCP-04: Uniform Billing Form OWCP
OWCP-1: Agreement and Undertaking (Self-Insured Employer) OWCP
OWCP-1168: Provider Enrollment form OWCP
OWCP-1500: Health Insurance Claim Form OWCP
OWCP-16: Rehabilitation Plan and Award OWCP