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Illinois workers' compensation commission 701. Web employers shall report to the commission all injuries resulting in the loss of more than three scheduled workdays. By law, employers must keep accurate. Web please send this form.

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Please send this form to: Web please send this form to: Illinois workers' compensation commission 4500 s. Web form revised 9/2023 il form 45 | page 1 of 1. Employer's fein date of report case.

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Employer's first report of injury. Employee’s first report of injury please type or print date of report date of injury case or file # is this a lost workday case? Employer's name date of report..

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Web please send this form to: Web please send this form to: Web this is a supplemental form that you need to complete and submit to the illinois workers’ compensation commission (along with form ic45).

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Filing this form does not affect liability under the workers'. Please send this form to: By law, employers must keep accurate. Web this is a supplemental form that you need to complete and submit to.

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Web employers shall report to the commission all injuries resulting in the loss of more than three scheduled workdays. Illinois workers' compensation commission 701. Employer's first report of injury. 701 s second st., springfield il.

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Illinois workers' compensation commission 4500 s. Illinois workers' compensation commission 701. Web please send this form to: Web employers shall report to the commission all injuries resulting in the loss of more than three scheduled.

Illinois workers' compensation commission 701. Employer’s first report of injury. Please send this form to: Employers shall report to the commission all. Web please send this form to:

Case or file # #3. 701 s second st., springfield il 62704. Employee’s first report of injury please type or print date of report date of injury case or file # is this a lost workday case?

Employer’s First Report Of Injury.

Web please fax the completed form to: Web form revised 9/2023 il form 45 | page 1 of 1. Employers shall report to the commission all. Illinois workers' compensation commission 4500 s.

Please Send This Form To:

Employer's fein date of report case or file # is this a lost workday case? Web employers shall report to the commission all injuries resulting in the loss of more than three scheduled workdays. Web please send this form to: Illinois workers' compensation commission 4500 s.

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Please send this form to: Web please send this form to the illinois industrial commission 701 s. Case or file # #3. Employer's first report of injury please type or print.

Employer's First Report Of Injury.

Employers first report of injury or illness. Web this is a supplemental form that you need to complete and submit to the illinois workers’ compensation commission (along with form ic45) when workers’ compensation. 701 s second st., springfield il 62704. Employer's name date of report.

Illinois workers' compensation commission 4500 s. Employer’s first report of injury. By law, employers must keep accurate. To be completed by the employee. Web this is a supplemental form that you need to complete and submit to the illinois workers’ compensation commission (along with form ic45) when workers’ compensation.