Form preview

Get the free COVID-19 Employer Reporting Form (CA SB-1159)

Get Form
LAP Claims Solutions, IncCOVID19 Occurrence Reporting Form Reporting Requirements per SB 1159 (Employers subject to a civil penalty of up to $10,000 for failure to report)Form must be submitted for
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign covid-19 employer reporting form

Edit
Edit your covid-19 employer reporting form form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your covid-19 employer reporting form form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing covid-19 employer reporting form online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use the professional PDF editor, follow these steps below:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit covid-19 employer reporting form. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Get your file. Select your file from the documents list and pick your export method. You may save it as a PDF, email it, or upload it to the cloud.
With pdfFiller, it's always easy to work with documents. Check it out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out covid-19 employer reporting form

Illustration

How to fill out covid-19 employer reporting form

01
Obtain a copy of the covid-19 employer reporting form from your HR department or the relevant authority.
02
Fill in the employer details section with accurate information including name, address, and contact information.
03
Provide details of the covid-19 cases reported in your workplace including the number of cases, affected areas, and dates.
04
Include information on any steps taken to prevent the spread of covid-19 in the workplace.
05
Submit the completed form to the designated authority within the specified timeframe.

Who needs covid-19 employer reporting form?

01
Employers who have had confirmed cases of covid-19 in their workplace.
02
Authorities responsible for monitoring and managing covid-19 outbreaks in the community.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.6
Satisfied
22 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

pdfFiller’s add-on for Gmail enables you to create, edit, fill out and eSign your covid-19 employer reporting form and any other documents you receive right in your inbox. Visit Google Workspace Marketplace and install pdfFiller for Gmail. Get rid of time-consuming steps and manage your documents and eSignatures effortlessly.
Create, modify, and share covid-19 employer reporting form using the pdfFiller iOS app. Easy to install from the Apple Store. You may sign up for a free trial and then purchase a membership.
You can make any changes to PDF files, like covid-19 employer reporting form, with the help of the pdfFiller Android app. Edit, sign, and send documents right from your phone or tablet. You can use the app to make document management easier wherever you are.
The covid-19 employer reporting form is a document used by employers to report cases of COVID-19 among their employees.
Employers are required to file the covid-19 employer reporting form.
To fill out the covid-19 employer reporting form, employers need to provide information about COVID-19 cases among their employees.
The purpose of the covid-19 employer reporting form is to track and monitor COVID-19 cases in the workplace.
Employers must report information such as the number of COVID-19 cases, the affected employees' details, and the steps taken to prevent the spread of the virus.
Fill out your covid-19 employer reporting form online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.