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Description of saif form
Notify SAIF Corporation within five days of knowledge of the claim. Even if the worker does not wish to file a claim maintain a copy of this form. 30. 800. 285. 8525 1. 800. 475. 7785 Report of Job Injury or Illness EMPLOYER S ACCOUNT NO. Workers compensation claim Worker To make a claim for a work-related injury or illness fill out the worker portion of this form and give to your employer. If you do not intend to...
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SAIF X801 Form Versions

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SAIF X801 2016 4.8 Satisfied
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SAIF X801 2011 4.2 Satisfied
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