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Section E Bankruptcy Date of Insolvency Contact Person s Name Name of Receiver or Trustee Contact Phone Number A 635 REV FEB 2014 Page 2 of 2 Section F - Sale of Business Type of Sale Amalgamation Share Acquisition Date of Sale Sale of all assets Partial sale of assets What type of relationship exists between the purchaser and seller Other Is there any common ownership between the Business Personal Please list what assets have been sold Solicitor s Name Solicitor s Phone Number Purchaser s Company Name Purchaser Address Purchaser Phone Number Will there be continuous ownership Purchaser Fax Number Will workers and equipment be continued Section G Applicant Authorization By my signature I certify that I have the authority to execute this request and the facts set forth on this application are true and correct to the best of my knowledge and belief. I am aware that any person operating in a compulsory industry who does not secure or maintain Workers Compensation coverage and comply with ....

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Federal Workers' Compensation Injured postal workers are required to fill in form CA-17, which is a form which outlines information from a doctor forbidding an injured federal employee from carrying out certain activities due to their inherently physically taxing nature.

Leave Buy Back. Compensation for Leave without Pay. The CA-7 must be filed electronically through the Employees' Compensation Operations & Management Portal (ECOMP). If you do not already have an account, one must be created at http://.ecomp.dol.gov.

Form 1032 reports results of a field review for a Mortgage secured by a 1-unit property originated using an appraisal report.

CA-16s can be approved and provided only by a postal supervisor. A properly issued CA-16 must have the name, title and signature of the authorizing official. CA-16s are not available online—for a very good reason. Only the au- thorizing agency has the authority to provide the CA-16.

Form CA-16 - Authorization for Examination and/or Treatment. This form guarantees payment to the care provider if the employee requires medical treatment because of a work-related traumatic injury. Your supervisor should complete page 1 of Form CA-16 and provide it to you for your attending physicians information.

CA-5. Subject. Claim for Compensation by Widow, Widower, and/or Children.

The employer shall issue Form CA-16 within 4 hours of the claimed injury. If the employer gives verbal authorization for such care, he or she should issue a Form CA-16 within 48 hours. The employer is NOT required to issue a Form CA-16 more than one week after the occurrence of the claimed injury.

select a physician of his/her choice to provide necessary treatment. The supervisor shall immediately authorize examination and appropriate medical care by use of Form CA-16 issued to either a United States medical office or hospital or any duly qualified physician/ hospital of the employee's choice.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232