State of Connecticut Forms in Word
CT Workers’ Comp Forms:
|
Connectiicut Workers’ Compensation Form Number |
CT Form Title | Price | Buy Now |
| CT HIPAA Form | Authorization for Release of Medical Records | $12.99 | |
| CT Form | Commutation and What It Means | $12.99 | |
| CT Form | Employee Medical & Work Status Form | $12.99 | |
| CT Form | Employer’s First Report of Occupational Injury or Illness | $12.99 | |
| CT Form | Employer Medical Care Plan Application Package | $12.99 | |
| CT Form | Employer Safety and Health Committee Information Package | $12.99 | |
| CT Form | Employer Self-Insurance Application Package | $12.99 | |
| CT Form 1A | FILING STATUS AND EXEMPTION FORM | $12.99 | |
| CT Form 6B | COVERAGE ELECTION BY EMPLOYEE WHO IS AN OFFICER OF A CORPORATION, MANAGER OF AN LLC, OR MEMBER OF A MULTIPLE-MEMBER LLC | $12.99 | |
| CT Form 6B-1 | COVERAGE ELECTION BY EMPLOYEES WHO ARE MEMBERS OF A PARTNERSHIP | $12.99 | |
| CT Form 7A | PROOF OF WORKERS’ COMPENSATION COVERAGE WHEN APPLYING FOR A BUILDING PERMIT FOR THE SOLE PROPRIETOR OR PROPERTY OWNER WHO WILL NOT ACT AS GENERAL CONTRACTOR OR PRINCIPAL EMPLOYER | $12.99 | |
| CT Form 7B | PROOF OF WORKERS’ COMPENSATION COVERAGE WHEN APPLYING FOR A BUILDING PERMIT FOR THE SOLE PROPRIETOR OR PROPERTY OWNER WHO WILL ACT AS GENERAL CONTRACTOR OR PRINCIPAL EMPLOYER | $12.99 | |
| CT Form 7C | PROOF OF WORKERS’ COMPENSATION COVERAGE WHEN APPLYING FOR A BUILDING PERMIT FOR THE GENERAL CONTRACTOR OR PRINCIPAL EMPLOYER WHO HAS CHOSEN TO BE EXCLUDED FROM COVERAGE | $12.99 | |
| CT Form 30C | NOTICE OF CLAIM FOR COMPENSATION (EMPLOYEE TO COMMISSIONER AND TO EMPLOYER) | $12.99 | |
| CT Form 30D | DEPENDENT’S NOTICE OF CLAIM (TO COMMISSIONER AND TO EMPLOYER) | $12.99 | |
| CT Form 36 | NOTICE OF INTENTION TO REDUCE OR DISCONTINUE PAYMENTS | $12.99 | |
| CT Form 42 | PHYSICIAN’S PERMANENT IMPAIRMENT EVALUATION | $12.99 | |
| CT Form 43 | NOTICE TO COMPENSATION COMMISSIONER AND EMPLOYEE OF INTENTION TO CONTEST EMPLOYEE’S RIGHT TO COMPENSATION BENEFITS compensation benefits. | $12.99 | |
| CT Form 44 | ORDER TO SECOND INJURY FUND IN CASES OF CONCURRENT EMPLOYMENT | $12.99 | |
| CT Form 75 | COVERAGE ELECTION BY SOLE PROPRIETOR OR SINGLE-MEMBER LLC | $12.99 | |
| CT Form 98 | MANDATORY NOTICE TO DEPENDENTS BY EMPLOYER OR INSURER TO BE FILED UPON DEATH OF EMPLOYEE WHO IS RECEIVING WEEKLY DISABILITY BENEFITS | $12.99 | |
| CT Form WCR-1 | WCR-1 “REHABILITATION REQUEST | $12.99 | |
| CT Hearing Cancellation Request | HEARING CANCELLATION REQUEST | $12.99 | |
| CT Hearing Request | HEARING REQUEST | $12.99 | |
| CT Mileage Worksheet t | MILEAGE WORK SHEET FOR MEDICAL TREATMENT/EXAM/PHYSICAL THERAPY/LABORATORY TEST | $12.99 | |
| CT Notice to Employees | NOTICE TO EMPLOYEES | $12.99 | |
| CT Notification of Appearance | NOTIFICATION OF APPEARANCE | $12.99 | |
| CT Petition for Review | PETITION FOR REVIEW | $12.99 | |
| CT Record of Employment Contacts | RECORD OF EMPLOYMENT CONTACTS | $12.99 | |
| CT Stipulation Approval Procedure | STIPULATION APPROVAL PROCEDURE | $12.99 | |
| CT Stipulation and What It Means | STIPULATION AND WHAT IT MEANS | $12.99 | |
| CT Stipulation TO DATE and What It Means | STIPULATION TO DATE AND WHAT IT MEANS | $12.99 | |
| CT Stipulation Questionnaire | STIPULATION QUESTIONNAIRE | $12.99 | |
| CT VA Form | VOLUNTARY AGREEMENT | $12.99 |
Other Connecticut State Forms
| Form No. | Form Title | Price | Buy Now |
| CT-706 NT | Connecticut Estate Tax Return (for Nontaxable Estates) (4 pages) | $12.99 | |
| CT-706/709 | Connecticut Estate and Gift Tax Return (4 pages) | $12.99 |