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Form PERA-1 Joint Request for Certification - Pennsylvania
What Is Form PERA-1?
This is a legal form that was released by the Pennsylvania Department of Labor & Industry - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is PERA-1?
A: PERA-1 is a joint request for certification form in Pennsylvania.
Q: Who needs to complete PERA-1?
A: Both the employee and the employer need to complete PERA-1.
Q: What is the purpose of PERA-1?
A: PERA-1 is used to request certification for job-related injuries or occupational diseases.
Q: What information is required on the PERA-1 form?
A: The PERA-1 form requires information about the employee, the employer, the injury or disease, and medical treatment.
Q: What should I do if I need assistance with completing the PERA-1 form?
A: If you need assistance, you can contact the Pennsylvania Labor and Industry's Bureau of Workers' Compensation.
Form Details:
- Released on May 1, 2009;
- The latest edition provided by the Pennsylvania Department of Labor & Industry;
- 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 Form PERA-1 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Labor & Industry.
Download Form PERA-1 Joint Request for Certification - Pennsylvania
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