Instructions in Spanish for completing the form F245-072-000 Statement for Miscellaneous Services
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
 Instructions in Spanish for completing the form F245-072-000 Statement for Miscellaneous Services (104 KB PDF)
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| Description | Instructions in Spanish for completing the form F245-072-000 Statement for Miscellaneous Services | |
| Detail | ||
| Form number | F245-072-999 | |
| Availability | Online only. See document above to download. |
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| Keywords | claims, dental, espanol, eye glasses, home services, industrial insurance, medical equipment, orthotics, prosthetics, reimbursement, retraining, transportation, worker's compensation, workers compensation, workers' compensation | |
| Languages | Spanish , English | |
| Valid dates | 04-2010 | |
| Contact information |
Claims for Job Injuries
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