EMPLOYER’S REPORT OF INDUSTRIAL INJURY
EMPLOYER’S REPORT OF INDUSTRIAL INJURY COMPLETE AND MAIL THIS REPORT WITHIN ... INDUSTRIAL COMMISSION OF ARIZONA P.O. BOX 19070 PHOENIX, ARIZONA 85005-9070 MAIL COPY TO:
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EMPLOYER’S REPORT INDUSTRIAL COMMISSION OF ARIZONA FOR CARRIER USE ...
OF INDUSTRIAL INJURY P.O. BOX 19070. PHOENIX, ARIZONA 85005-9070. COMPLETE AND MAIL THIS REPORT WITHIN 10 FOR OSHA PURPOSES ONLY . DAYS FROM NOTICE OF ACCIDENT.
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ICA Forms
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The Phoenix Fire Department shall make every reasonable effort to provide a safe and healthy ... INDUSTRIAL INJURY REPORTS
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Instruction
... report it within 10 days using an Employer’s Report of Industrial Injury ... The original copy of Form 101 should be mailed to: Industrial Commission of Arizona P.O. Box 19070. Phoenix, AZ ...
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