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REPORT OF INJURY / COMPLAINT OF INJURY PROFESSIONAL LICENSING AGENCY 402 West Washington Street, Room W072 Indianapolis, Indiana 46204 (317) 2343031 www.IN.gov/pla Reset Form State Form 47400 (R /

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What is report of injury complaint?

The report of injury complaint is a document that details an injury or incident that occurred in the workplace.

Who is required to file report of injury complaint?

Employers are usually required to file the report of injury complaint with the appropriate authorities.

How to fill out report of injury complaint?

The report of injury complaint can usually be filled out online or on paper, depending on the requirements of the regulating agency.

What is the purpose of report of injury complaint?

The purpose of the report of injury complaint is to document workplace injuries and incidents for recordkeeping and regulatory compliance purposes.

What information must be reported on report of injury complaint?

The report of injury complaint typically requires details such as the date and time of the incident, location, description of the injury, and any witnesses.

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