Form 1 – Employee’s Claim & Employer’s First Report of Injury – Rev 9/11 | Department of Labor

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Workers' Comp Forms

Form 1 – Employee’s Claim & Employer’s First Report of Injury – Rev 9/11

Friday, May 24, 2019

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Form 1 – Employee’s Claim & Employer’s First Report of Injury – Rev 9-11 .pdf

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Vermont Department of Labor
5 Green Mountain Drive
P.O. Box 488
Montpelier, 05601-0488
(802) 828-4000

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