Application for Inclusion on List of Eligible Attorneys
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
||
| Title |
Application for Inclusion on List of Eligible Attorneys (A fillable form - 65 KB PDF)
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|
| Description | Used by attorneys to be included on the Workers' Compensation Special Assistant Attorney General Program eligible list for Third Party claims. | |
| Detail | ||
| Form number | F249-017-000 | |
| Availability | Online only. See document above to download. |
|
| Keywords | AAG, claims, industrial insurance, lawyer, worker's compensation, workers compensation | |
| Languages | English | |
| Valid dates | 08-2011 | |
| Contact information |
Third Party Claim Cost Recovery
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|
| Web pages | Workers' Comp Claims Injured by a Third Party? |
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