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This form is to be used by clearing agencies to apply for registration or exemption from registration as a clearing agency with the SEC and to amend such registration as necessary. It outlines the

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How to fill out form ca-1

01

Obtain a copy of Form CA-1 from the appropriate source, such as the U.S. Department of Labor website.

02

Fill in the employee's personal information, including name, address, and contact details.

03

Indicate the date and time of the injury or traumatic event.

04

Provide a detailed description of how the injury occurred.

05

Include information about any witnesses to the incident, if applicable.

06

Fill in the section regarding medical attention, including the names of any doctors or hospitals visited.

07

Review all the information for accuracy and completeness.

08

Sign and date the form.

09

Submit the completed form to the appropriate agency, typically your supervisor or the HR department.

Who needs form ca-1?

01

Form CA-1 is typically needed by federal employees who have experienced a traumatic injury while in the performance of their duties.

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What is form ca-1?

Form CA-1 is a Federal employee's notice of traumatic injury and claim for continuation of pay/compensation, used to report a traumatic injury that occurred during the performance of duty.

Who is required to file form ca-1?

Federal employees who suffer a traumatic injury in the course of their job duties are required to file Form CA-1 to seek continuation of pay or compensation benefits.

How to fill out form ca-1?

To fill out Form CA-1, an employee should provide personal information, details of the injury, the circumstances surrounding the incident, and any medical treatment received, ensuring all sections are completed accurately.

What is the purpose of form ca-1?

The purpose of Form CA-1 is to document incidents of traumatic injury that occur during employment and to facilitate claims for compensation and continuation of pay for affected employees.

What information must be reported on form ca-1?

Form CA-1 must report information such as employee's personal details, the date and time of the injury, location of the incident, a description of the injury, and witness information.

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