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Connecticut Notice of Claim for Compensation Form 30C
SKU: FFCT170 |   E-mail this product to a friend
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Product Description

The Form 30C “NOTICE OF CLAIM FOR COMPENSATION (EMPLOYEE TO COMMISSIONER AND TO EMPLOYER)” is to be completed and filed by a claimant (employee) or claimant’s attorney/representative for making a claim for workers’ compensation benefits. The Form 30C includes a map of Connecticut’s 169 cities and towns and their respective workers’ compensation districts, as well as instructions for completing and filing this form and a listing of district office contact information.
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