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WCC Form H-05 Claimant's Affidavit in Support of Settlement - Maryland
What Is WCC Form H-05?
This is a legal form that was released by the Maryland Workers' Compensation Commission - a government authority operating within Maryland. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is WCC Form H-05?
A: WCC Form H-05 is the Claimant's Affidavit in Support of Settlement for workers' compensation cases in Maryland.
Q: What is the purpose of WCC Form H-05?
A: The purpose of WCC Form H-05 is to provide a sworn statement from the claimant in support of a settlement in a workers' compensation case.
Q: Who needs to fill out WCC Form H-05?
A: The claimant, or their legal representative, needs to fill out WCC Form H-05.
Q: What information is required in WCC Form H-05?
A: WCC Form H-05 requires the claimant to provide personal information, details about the injury, medical treatment received, and employment history.
Q: Is WCC Form H-05 specific to Maryland?
A: Yes, WCC Form H-05 is specific to workers' compensation cases in Maryland.
Form Details:
- Released on December 1, 2009;
- The latest edition provided by the Maryland Workers' Compensation Commission;
- 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 fillable version of WCC Form H-05 by clicking the link below or browse more documents and templates provided by the Maryland Workers' Compensation Commission.
