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This version of the form is not currently in use and is provided for reference only. Download this version of
Form PERS-BSD-92
for the current year.
Form PERS-BSD-92 Workers' Compensation Carrier Request - California
What Is Form PERS-BSD-92?
This is a legal form that was released by the California Public Employees' Retirement System - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form PERS-BSD-92?
A: Form PERS-BSD-92 is a Workers' Compensation Carrier Request form.
Q: What is the purpose of Form PERS-BSD-92?
A: The purpose of Form PERS-BSD-92 is to request information from the workers' compensation carrier in California.
Q: Who needs to fill out Form PERS-BSD-92?
A: Employers or their authorized representative need to fill out Form PERS-BSD-92.
Q: Is Form PERS-BSD-92 specific to California?
A: Yes, Form PERS-BSD-92 is specific to California.
Q: Are there any fees associated with submitting Form PERS-BSD-92?
A: There are no fees associated with submitting Form PERS-BSD-92.
Q: What information is required on Form PERS-BSD-92?
A: Form PERS-BSD-92 requires information such as employer details, injured worker details, and details of the claim.
Q: What should I do after filling out Form PERS-BSD-92?
A: After filling out Form PERS-BSD-92, you should submit it to your workers' compensation carrier or the relevant state agency.
Form Details:
- Released on November 1, 2011;
- The latest edition provided by the California Public Employees' Retirement System;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form PERS-BSD-92 by clicking the link below or browse more documents and templates provided by the California Public Employees' Retirement System.
Download Form PERS-BSD-92 Workers' Compensation Carrier Request - California
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