Free WC Order Form - Alabama


File Size: 12.2 kB
Pages: 1
File Format: PDF
State: Alabama
Category: Workers Compensation
Author: mfs
Word Count: 287 Words, 2,405 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://dir.alabama.gov/docs/forms/wc_order_form.pdf

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The Department of Industrial Relations makes available the following aid to assist the public in becoming knowledgeable of Departmental operations. UNIT TOTAL DESCRIPTION PRICE AMOUNT QTY. $35.00 $_______ ____ Copy of DIR Administrative Code. This is a loose leaf copy of all Department Administrative Rules. Updates will be provided by subscribing to the Advance Notice of Rulemaking Proceedings. ____ Subscription to Advance Notice of Rulemaking Proceedings for one year. This is notification by letter of rule making hearings and the adoption of emergency rules. You will be sent a subscription form at the end of the fiscal year. Direct product/service questions to Teresa Davis, (334) 242-2868. $25.00 $_______

____

Copy of the 2006 Edition of the Workers' Compensation Law Book Annotated. This is a reprint of the Code of Alabama, 1975, Section 25-5. You will be sent an order form when future editions become available. 2008 Alabama Workers' Compensation Maximum Fee Schedules

$29.00

$_______

This may be ordered in printed booklet form, CD, and/or Email format. Electronic version is Word or Excel. ____ PRINTED booklet of Workers' Compensation Fee Schedules for Medical Providers. $51.00 $_______

____

CD COPY of Workers' Compensation Fee Schedules for Medical Providers

$36.00

$_______

____

DISCOUNT PACKAGE (Save $25.00) Printed Booklet & CD

$66.00

$_______

____

E-MAIL COPY of Workers' Compensation Fee Schedules for Medical Providers

$29.00

$_______

Direct product/service questions to Trevor Perry, (334) 242-2868 or 1800-528-5166.

Please fill in the following:

Total Enclosed

$_______

Contact Name______________________________________________________________________________________ Business Name_____________________________________________________________________________________ Address___________________________________________________________________________________________ City _______________________________________________ State Telephone Number ( ) __________________________________________ Zip_______________

E-mail address _________________________________________________________________________________ Please send this order form with a check or money order made payable to Alabama Department of Industrial Relations to: Alabama Department of Industrial Relations Finance Division ATTN: Central Cashier 649 Monroe Street Montgomery, AL 36131-2270