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Form LB1095-A Addendum to Petition for Benefit Determination for Death Claims Only - Tennessee
What Is Form LB1095-A?
This is a legal form that was released by the Tennessee Department of Labor and Workforce Development - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form LB1095-A?
A: Form LB1095-A is an addendum to the Petition for Benefit Determination for Death Claims Only in the state of Tennessee.
Q: What is the purpose of Form LB1095-A?
A: The purpose of Form LB1095-A is to provide additional information or clarification regarding a death claim for benefits in Tennessee.
Q: Who uses Form LB1095-A?
A: Form LB1095-A is used by individuals or representatives filing a death claim for benefits in Tennessee.
Q: Is Form LB1095-A specific to Tennessee?
A: Yes, Form LB1095-A is specific to the state of Tennessee.
Form Details:
- Released on August 1, 2021;
- The latest edition provided by the Tennessee Department of Labor and Workforce Development;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form LB1095-A by clicking the link below or browse more documents and templates provided by the Tennessee Department of Labor and Workforce Development.
