Nebraska Department of Administrative Services Forms

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101

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This document is a pledge form for the Campaign Against Hunger Virtual Drive in Nebraska.

This form is used for designating beneficiaries for compensation under the Line of Duty Compensation Act in Nebraska.

This document is used for filing a non-foster parent care claim in the state of Nebraska.

This Form is used for determining workability eligibility in Nebraska.

This form is used for requesting a medical accommodation from a healthcare provider in the state of Nebraska.

This document is used for reporting any incidents involving employees in the state of Nebraska. It helps to document and keep a record of any workplace accidents, injuries, or other incidents that occur in the workplace.

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