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FAX# (505× 2779006 FIRST REPORT OF ACCIDENT WPA E1.1 RETURN TO:UNM SAFETY AND RISK SERVICES BUILDING 233 THIS FORM TO BE COMPLETED BY EMPLOYEE AND HIS×HER SUPERVISOR 1. Name of Employer 2. Department
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What is this form to be?
This form is to be used for reporting certain information to the authorities.
Who is required to file this form to be?
Entities or individuals meeting certain criteria are required to file this form.
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The purpose of this form is to collect relevant information for regulatory purposes.
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