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Unemployment Insurance	Workers' Compensation

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Product	SKU	More Info
Texas / The Clerk. He / She Intends to Request Permission to the Division Spanish DWC054S	FFTX295
Texas Accident Prevention Plan Cover Sheet DWC102	FFTX525
Texas Accident Prevention Services Annual Report DWC109	FFTX565
Texas Accident Prevention Services Worksheet DWC105	FFTX555
Texas Agreement Between General Contractor and Subcontractor to Establish Independent Relationship DWC085	FFTX035
Texas Agreement Between General Contractor and Subcontractor to Establish Independent Relationship DWC085S	FFTX040
Texas Agreement Between General Contractor and Sub-Contractor to Provide Worker's Compensation DWC081	FFTX005
Texas Agreement Between the Contractor General and the Sub Contractor DWC081S	FFTX010
Texas Agreement Dispute Benefits DWC025S	FFTX085
Texas Agreement for Certain Building and Construction Workers DWC083	FFTX020
Texas Agreement for Certain Workers building and construction DWC083S	FFTX025
Texas Agreement for Motor Carriers and Owner Operators DWC082	FFTX015
Texas Agreement to Benefit Dispute DWC024s	FFTX075
Texas Application for Adjustment of an Average Weekly Wage (a) Employee / a Season DWC055S	FFTX305
Texas Application for Attorney's Fees DWC152 - Cover	FFTX660
Texas Application for Division Approval of Change in the Payment Period DWC031	FFTX100
Texas Application for Division Approval of the Purchase of an Annuity for Lifetime Income Benefit DWC035	FFTX120
Texas Application for Reimbursement from the Return-to-Work Account for Small Employers DWC008	FFTX510
Texas Application for Supplemental Income Benefits DWC052	FFTX270
Texas Application of the Texas Workers Injured About Advance Payment of Compensation DWC047S	FFTX255
Texas Applications for a Texas Medical Appointed DWC032S	FFTX110
Texas Attorney Application for Web Access DWC151	FFTX655
Texas Benefit Dispute Agreement cover sheet DWC024	FFTX070
Texas Benefit Dispute Settlement DWC025	FFTX080
Texas Carrier Representative Information Submission Form DWC027	FFTX095
Texas Carrier's Request for Reduction of Income Benefits Due to Contribution DWC033	FFTX115
Texas Carrier's Request for Seasonal Employee Wage Information from Texas Workforce Commission DWC056	FFTX310
Texas Certification and Approval of a Possible Job Spainsh DWC156S	FFTX685
Texas Correction/Revision/Endorsement to Existing Policy DWC020A	FFTX050
Texas Declaration of Employer's Salary Spanish DWC003S	FFTX460
Texas Declaration of Multiple Jobs Salary Employee Spanish DWC003MES	FFTX165
Texas Declaration of Salary To Schools District DWC003SDS	FFTX470
Texas Designated Address	FFTX945
Texas Documentary Irrevocable Standby Letter of Credit ("Confirmation") DWC224	FFTX870
Texas Documentary Irrevocable Standby Letter of Credit DWC223	FFTX860
Texas DWC Form-060S. Request for Dispute Resolution of Medical Fees DWC060S	FFTX600
Texas Election to Engage in Arbitration DWC044	FFTX220
Texas Employee's Claim for Compensation for a Work-Related Injuries Disease DWC041S	FFTX190
Texas Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease DWC041	FFTX180
Texas Employee's Election for Commuted (Lump Sum) Impairment Income Benefits DWC051	FFTX265
Texas Employee's Multiple Employment Wage Statement DWC003ME	FFTX160
Texas Employee's Request for Acceleration of Impairment Income Benefits DWC046	FFTX240
Texas Employee's Request for Payment of Advanced Compensation DWC047	FFTX250
Texas Employee's Request To Change Treating Doctors - Non Network DWC053	FFTX280
Texas Employer Request for DWC Safety Consultation DWC104	FFTX540
Texas Employer's Contest of Compensability DWC004	FFTX475
Texas Employer's First Report of Injury or Illness (for state employees) DWC001S	FFTX435
Texas Employer's First Report of Injury or Illness DWC001	FFTX430
Texas Employer's Notice of No Coverage or Termination of Coverage DWC005	FFTX480
Texas Employer's Report for Reimbursement of Voluntary Payment DWC002	FFTX440
Texas Employer's Wage Statement DWC003	FFTX445
Texas Employer's Wage Statement for School Districts DWC003SD	FFTX465
Texas Exception to Application of Joint Agreement for Certain Building and Construction Workers DWC084	FFTX030
Texas Explanation of Benefits DWC062	FFTX610
Texas Implementation of the Employee Benefits for Supplemental Income Spanish DWC052S	FFTX275
Texas Instructions For Completing The ADA J515 Dental Claim Form For Texas Workers' Compensation DWC070	FFTX630
Texas Insurance Carrier's Notice of Coverage/Cancellation/Non-Renewal of Coverage DWC020	FFTX045
Texas Locations of Employers' Business(es) DWC205	FFTX350
Texas Mass Claims Agreement Letter	FFTX970
Texas Mass Claims Excel Spreadsheet and Instructions	FFTX975
Texas Mass Claims Information	FFTX955
Texas Maximum Medical Improvement/First Impairment Income Benefit Payment (124.2(e)(1)(4)&(5)) PLN03	FFTX720
Texas Medical Fee Dispute Resolution Request DWC060	FFTX595
Texas New Employee Notice - English	FFTX355
Texas New Employee Notice - Spanish	FFTX360
Texas New Employee Notice -English	FFTX380
Texas New Employee Notice -Spanish	FFTX385
Texas Non-ADL Doctor Request for Case-By-Case Exception DWC075	FFTX645
Texas Non-Covered Employer's Report of Occupational Injury and Illness DWC007	FFTX495
Texas Non-Covered Employer's Report of Occupational Injury and Illness, Supplement DWC 7 DWC007SUP	FFTX345
Texas Notice 5 -English	FFTX365
Texas Notice 5 Rules	FFTX370
Texas Notice 5 -Spanish	FFTX375
Texas Notice 6 -English	FFTX390
Texas Notice 6 Rules	FFTX395
Texas Notice 6 -Spanish	FFTX400
Texas Notice 8 - Spanish	FFTX410
Texas Notice 8 -English	FFTX405
Texas Notice 9 - Spanish	FFTX425
Texas Notice 9 -English	FFTX415

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