| Información del documento | ||
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| Título |
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| Descripción | Used by the worker to designate a person(s) as an authorized representative for the worker's claim. An authorized representative can access claim information. | |
| Detalle | ||
| Número del formulario | F101-010-000 | |
| Disponibilidad | ordénelo | |
| Palabras claves | claims, designee, espanol, industrial insurance, spanish, worker's compensation, workers compensation, workers' compensation | |
| Idiomas | English, Spanish | |
| Fechas válidas | 04-2006 | |
| Contacto |
Managing Injured Workers' Claims
Claims for Job Injuries |
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| Páginas de Internet | Workers' Comp Claims | |