Alabama First Report PDF Details

The Alabama First report, commissioned by the Business Council of Alabama (BCA), offers a detailed examination of Alabama's business climate. The report assesses the state's strengths and weaknesses with respect to its ability to promote and sustain economic growth. It also provides recommendations for improving the state's business climate. Overall, the findings suggest that Alabama is still in need of significant improvements if it wants to compete with other states in terms of attracting new businesses and creating jobs.

The table contains details about the alabama first report. You might like to study it just before submitting the gaps.

QuestionAnswer
Form NameAlabama First Report
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesal form report, wcc form 2, first report of injury form alabama fillable, state of alabama first report of injury form

Form Preview Example

THE USE OF THIS FORM IS REQUIRED UNDER THE PROVISIONS OF THE ALABAMA WORKMEN’S COMPENSATION LAW

WCC Form 2

Rev. 10/2012STATE OF ALABAMA

EMPLOYER’S FIRST REPORT OF INJURY

OR OCCUPATIONAL DISEASE

CLAIM REFERENCE

 

 

1. Insured Report Number

 

 

2. Filing Office Claim Number

 

 

 

 

 

3. OSHA Log Case Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. Employer Business Name

 

 

 

 

 

 

ADDRESS, IF LOCATION DIFFERENT FROM BUSINESS ADDRESS

 

 

 

5. Physical Address 1

 

 

 

 

 

 

 

 

10. Mailing Address 1

 

 

 

 

 

 

 

 

 

 

 

 

6. Physical Address 2

 

 

 

 

 

 

 

 

11. Mailing Address 2

 

 

 

 

 

 

 

 

 

 

 

 

7. City

 

 

 

 

8. State

 

9. Zip

 

12. City

 

 

 

 

 

 

 

 

13. State

14. Zip

 

 

 

15. Federal ID Number

 

 

16. U.C. Account Number

 

 

 

 

 

17. NAICS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURER / FILING OFFICE

 

 

 

 

 

 

 

 

 

 

 

18.

Insurer Name

 

 

 

 

 

 

 

 

 

21. Filing Office Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22. Mailing Address 1

 

 

 

 

 

 

 

 

 

 

 

19.

Insurer Federal ID Number

 

 

 

 

 

23. Mailing Address 2 or Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24. City

 

 

 

 

 

 

 

 

25. State

26. Zip

 

 

20.

Type Insurer

Ins Co

Self-Insurer

 

Group Fund

 

27. Filing Office Federal ID Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYEE / WAGES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28. First Name

 

 

 

 

 

 

 

 

 

 

 

 

32. Employee ID Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29. Middle Name

 

 

 

 

 

 

 

 

 

 

 

 

33. Type Employee ID Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30.

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

SSN

Passport Number

Green Card

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31

Last Name Suffix

(ie. Jr., Sr., III)

 

 

 

 

 

 

 

 

Employment Visa

 

Assigned by Jurisdiction

 

 

34.

Mailing Address 1

 

 

 

 

 

 

 

 

 

 

 

 

40. Gender

 

 

 

41. Date of Birth

 

 

35.

Mailing Address 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Male

 

 

 

 

 

 

 

 

36.

City

 

 

 

37. State

 

38. Zip

39. Phone

 

 

 

 

 

Female

 

42.Nbr of Dependents

 

 

43.

Marital Status

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

44. Date Hired

 

 

 

 

 

Unmarried (Single or Divorced or Widowed)

 

Married

 

Separated

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

45.

Occupation Description

 

 

 

 

 

 

 

 

 

 

 

 

 

46. Number of Days Worked Per Week

 

 

47.

Wages $

 

 

 

 

 

 

 

 

 

49. Received Full Pay For Day of Injury?

 

Yes

No

 

 

 

48. Hourly

Daily

Weekly

Bi-weekly

 

Monthly

 

50. Did Salary Continue?

 

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INJURY / TREATMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

51.

Date of Injury

 

52. Time of Injury

 

 

53. Time Employee Began Work

 

54. Date Disability Began

 

55. Date of Death

 

 

 

 

 

 

 

 

a.m.

p.m.

unk

 

 

a.m.

p.m.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLACE OF ACCIDENT, INJURY, OR EXPOSURE

 

 

 

 

 

 

61. Injury Occurred on Employer’s Premises?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

56.

Site Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

57.

City

 

 

 

 

 

58. State

59. Zip

 

 

62. Date Employer Notified

 

 

 

 

 

60.

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

63. DESCRIBE WHAT THE EMPLOYEE WAS DOING JUST BEFORE THE INCIDENT AND HOW THE INJURY OCCURRED. ( Ex. While climbing a

ladder and carrying roofing materials, ladder slipped on wet floor causing worker to fall 20 feet.)

PROVIDE DESCRIPTION CODES to identify Nature of Injury, Part of Body that was affected, and Cause of Injury.

 

(FOR COMPLETE LIST OF CODES, GO TO HTTP:// LABOR.ALABAMA.GOV/WC

 

 

64. Nature of Injury Code

 

65. Part of Body Code

66.

 

Cause of Injury Code

67. Initial Treatment

No Medical Treatment

 

68.

Name of Treatment Facility

 

 

First Aid By Employer

Minor Clinic / Hospital

 

 

 

 

69.

Address

 

 

 

 

Emergency Room

Hospitalized Overnight

 

 

 

 

 

 

70.

City

71. State

 

72. Zip

Hospitalized > 24 Hours

Outpatient Treatment

 

 

 

 

 

 

 

 

 

 

73. Name of Physician or Other Health Care Professional

 

 

 

74. Has Injured Returned to Work

 

If so, 75. Date

 

 

 

 

 

 

Yes

No

 

76. Time

a.m. p.m.

 

 

 

 

 

 

 

 

 

 

OTHER

77. Date Prepared

78. Preparer’s First Name

79. Last Name

80. Title

81. Preparer’s Telephone Number

03/01/2006

How to Edit Alabama First Report Online for Free

Filling out alabama first report injury is a breeze. Our team developed our PDF editor to really make it simple to use and assist you to prepare any PDF online. Listed here are steps that you should stick to:

Step 1: Press the button "Get form here" to access it.

Step 2: So, you can begin modifying your alabama first report injury. The multifunctional toolbar is available to you - insert, eliminate, adjust, highlight, and conduct many other commands with the words and phrases in the document.

Type in the requested information in every section to get the PDF alabama first report injury

first report of injury alabama fields to complete

Complete the First Name Middle Name Last, Biweekly, Separated, Married, Monthly, Weekly, Daily, Unknown, Number of Days Worked Per Week, Received Full Pay For Day of, INJURY TREATMENT Time Employee, Date Disability Began, Date of Death, Date of Injury, and Time of Injury am fields with any particulars that are asked by the software.

Filling in first report of injury alabama step 2

In the Nature of Injury Code Part of, Name of Treatment Facility, Has Injured Returned to Work Yes, If so Date Time am pm, Date Prepared, Preparers First Name Last Name, Preparers Telephone Number, and OTHER area, highlight the relevant details.

step 3 to entering details in first report of injury alabama

Step 3: Hit the Done button to save the file. Now it is at your disposal for export to your electronic device.

Step 4: Get a duplicate of each separate file. It will certainly save you time and allow you to avoid troubles down the road. By the way, your data is not shared or monitored by us.

Watch Alabama First Report Video Instruction

Alabama First Report isn’t the one you’re looking for?

Related Documents

  • Autopsy Report Form

    "... Autopsy Form Completed by Date Patient Name Initials, Date of Birth. The patient's death was expected. Faculty name. Please print the following form for residency program administrators. Print patient room autopsy forms patient mr. Report ..."

  • 4 Point Inspection Report

    "... Property address, city and state zip code Inspector name Date of Inspection Type of Home Intern achi ID Number inspector Signature Inspector Address Type of Construction Square footage approximate Age of Client Owner Name Insurance ..."

  • Annual Credit Report Form

    "... If additional information is required, the consumer credit company will reach out to you by post. Your request will be processed within fifteen days. ..."

  • Auto Repair Order Template

    "... Written by year serial number no mileage when promised model name address state home telephone work zip date instructions labor total labor parts total accessory fluids fluids cost authorization to complete the above repairs along ..."

Please rate Alabama First Report

1 Votes

Related Resources

  • Forms - Alabama Department of Revenue

    B&L: CCEM-1, Coosa County Earthen Materials Severance Tax Report ... Instructions, Alabama Business Privilege Tax Initial Privilege Tax Return, Income Tax ...

  • Business Privilege Tax FAQ

    What taxpayers must file an Alabama Business Privilege Tax return? ... as corporations for federal income tax purposes must also file Alabama Form CPT.

  • DWC Form-001 - Texas Department of Insurance

    The employer is required to file an Employer's First Report of Injury or Illness. [DWC FORM-001 Rev. 10/05] with the injured worker's insurance carrier, ...

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .