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Form I-1 NORTH CAROLINA DEPARTMENT OF TRANSPORTATION EMPLOYEE? S STATEMENT Employee Name: Personnel # : Employee Title: Division: County: Date of Incident: Department #: Date Incident Reported: Description

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What is wc_form_i-1_employees_statement1doc - connect ncdot?

WC_FORM_I-1_Employees_Statement1doc is a form used by the North Carolina Department of Transportation (NCDOT) to collect information about employees who have suffered work-related injuries or illnesses.

Who is required to file wc_form_i-1_employees_statement1doc - connect ncdot?

Employers in North Carolina are required to file WC_FORM_I-1_Employees_Statement1doc if they have employees who have suffered work-related injuries or illnesses.

How to fill out wc_form_i-1_employees_statement1doc - connect ncdot?

To fill out WC_FORM_I-1_Employees_Statement1doc, employers need to provide information about the employee, including their name, social security number, date of birth, job title, date of injury or illness, and a description of the injury or illness.

What is the purpose of wc_form_i-1_employees_statement1doc - connect ncdot?

The purpose of WC_FORM_I-1_Employees_Statement1doc is to collect information about work-related injuries or illnesses in order to track and analyze workplace safety trends and facilitate the provision of workers' compensation benefits.

What information must be reported on wc_form_i-1_employees_statement1doc - connect ncdot?

WC_FORM_I-1_Employees_Statement1doc requires reporting of the employee's name, social security number, date of birth, job title, date of injury or illness, and a description of the injury or illness.

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