PDF
Word
State Form 18875 Agreement to Compensation Between the Dependents of Deceased Employee and Employer - Indiana
What Is State Form 18875?
This is a legal form that was released by the Indiana Workers' Compensation Board - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is State Form 18875?
A: State Form 18875 is an agreement to compensation between the dependents of a deceased employee and the employer.
Q: Who does State Form 18875 apply to?
A: State Form 18875 applies to the dependents of a deceased employee and the employer.
Q: What does State Form 18875 include?
A: State Form 18875 includes the agreement to compensation between the dependents of a deceased employee and the employer.
Q: What is the purpose of State Form 18875?
A: The purpose of State Form 18875 is to establish the compensation agreement between the dependents of a deceased employee and the employer.
Form Details:
- Released on May 1, 2010;
- The latest edition provided by the Indiana Workers' Compensation Board;
- 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 State Form 18875 by clicking the link below or browse more documents and templates provided by the Indiana Workers' Compensation Board.
