This is a legal form that was released by the Utah Labor Commission - a government authority operating within Utah. Check the official instructions before completing and submitting the form.
Q: What is Form 025?
A: Form 025 is an application for hearing-dependent benefits and/or burial benefits for an industrial accident claim in Utah.
Q: Who is eligible to apply for Form 025?
A: Those who are hearing-dependent and have a qualifying industrial accident claim in Utah are eligible to apply for Form 025.
Q: What are hearing-dependent benefits?
A: Hearing-dependent benefits are financial support provided to individuals who have become deaf or have suffered hearing loss as a result of an industrial accident.
Q: What are burial benefits?
A: Burial benefits are financial assistance provided to help cover the costs of funeral and burial expenses for a deceased individual who had a qualifying industrial accident claim.
Q: How can I obtain Form 025?
A: Form 025 can be obtained from the relevant authorities or agencies handling industrial accident claims in Utah.
Q: Is there a deadline for submitting Form 025?
A: Yes, there is a deadline for submitting Form 025. It is important to check with the relevant authorities or agencies for the specific deadline in your case.
Q: What documentation is required to accompany Form 025?
A: The documentation required to accompany Form 025 may vary. It is advisable to consult the relevant authorities or agencies to determine the specific documentation needed for your application.
Form Details:
Download a fillable version of Form 025 by clicking the link below or browse more documents and templates provided by the Utah Labor Commission.