SOUTH CAROLINA WORKERS' COMPENSATION COMMISSION
South Carolina Workers’ Compensation Commission
1333 Main Street, Suite 500
P.O. BOX 1715
Columbia, SC 29202-1715
(803) 737-5675 |[pic] |I.C. File #:
| |
The use of this form is required under the provisions of the South Carolina Workers’ Compensation Law.
NOTICE
OF
THIRD PARTY ACTION
EMPLOYEE
|In the Workers’ Compensation Claim of | |
| | |
| |, Employee |
| | |
| |, Claimant(s) |
| | |
|vs. | |
| | |
| |, Employer |
| | |
| |, Carrier |
| | |
| | |
|TO THE SOUTH CAROLINA WORKERS’ COMPENSATION COMMISSION and the above-named Carrier or Self-Insurer Employer: |
| |
| PLEASE TAKE NOTICE that an action has been commenced against | |
|as defendant(s) in the Court of | |
|County of | |and State of | |
|under date of | |, | |. |
| | | |
| | |Employee or Surviving Workers’ |
| | |Compensation Beneficiary |
|DATED: | | | | |
| | | |
| | |Attorney for Employee or Surviving Workers’ |
| | |Compensation Beneficiary |
| | | |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- south carolina workers compensation commission
- indian sovereignty and workers compensation
- wcab 3 california
- virginia workers compensation commission
- the basics of workers compensation
- alaska workers compensation board
- negligence the employer s duties
- workers compensation legislation and psychological injury
- illinois form 45 employer s first report of injury
Related searches
- ny workers compensation law
- workers compensation new york website
- new york workers compensation board
- workers compensation ny rules
- nys workers compensation board
- workers compensation new york guidelines
- workers compensation by state compar
- workers compensation laws
- workers compensation state by state
- workers compensation limits by state
- workers compensation caps by state
- workers compensation laws by state