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Form LIBC-211I Insurer's Initial Report of Accident & Illness Prevention Services - Pennsylvania
What Is Form LIBC-211I?
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 LIBC-211I?
A: LIBC-211I is the Insurer's Initial Report of Accident & Illness Prevention Services form in Pennsylvania.
Q: What is the purpose of LIBC-211I?
A: The purpose of LIBC-211I is to report accident and illness prevention services provided by the insurer.
Q: Who needs to fill out LIBC-211I?
A: The insurer needs to fill out LIBC-211I.
Q: Are there any fees associated with filling out LIBC-211I?
A: No, there are no fees associated with filling out LIBC-211I.
Form Details:
- Released on December 1, 2021;
- 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 LIBC-211I by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Labor & Industry.
Download Form LIBC-211I Insurer's Initial Report of Accident & Illness Prevention Services - Pennsylvania
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