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EMPLOYERS REPORT OF INDUSTRIAL INJURY COMPLETE AND SUBMIT THIS REPORT WITHIN 10 DAYS FROM NOTICE OF ACCIDENT. FATALITIES MUST BE REPORTED WITHIN 24 HOURS. Employer must, on this form, notify his insurance

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For carrier use only is a section on a form where information is intended solely for the carrier's use and should not be shared with others.

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Typically, carriers or shipping companies are required to fill out the for carrier use only section of a form.

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Information such as tracking numbers, internal references, or special instructions may be reported on for carrier use only.

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