State Form 54217 Notice of Suspension of Compensation and / or Benefits - Indiana

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of State Form 54217 for the current year.

State Form 54217 Notice of Suspension of Compensation and / or Benefits - Indiana

What Is State Form 54217?

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 Form 54217?
A: Form 54217 is the Notice of Suspension of Compensation and/or Benefits in Indiana.

Q: When is Form 54217 used?
A: Form 54217 is used when there is a suspension of compensation and/or benefits.

Q: Who uses Form 54217?
A: Form 54217 is used by the state of Indiana.

Q: What does Form 54217 notify?
A: Form 54217 notifies about the suspension of compensation and/or benefits.

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Form Details:

  • Released on March 1, 2013;
  • 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 54217 by clicking the link below or browse more documents and templates provided by the Indiana Workers' Compensation Board.

Download State Form 54217 Notice of Suspension of Compensation and / or Benefits - Indiana

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