All of the Department of Labor’s forms will be in PDF format. If you do not have a PDF reader, you can download a free one from. • • • • • • • • Wage & Hour Forms • • • Workplace Safety Forms • • Tramway Forms • • • • • Unemployment Insurance Forms Claimant Forms: • • • • • • • • • • • • • • • • Employer Forms: UI Employer Forms: • • • • • • • • • • • • • • • • • • • • • • • • STC Employer Forms • • • • • • • • Employee Leasing Forms • • • • • • • Workers’ Compensation Forms Workers’ Compensation Forms • • NOTE: The injured employee must receive a Form 8 and a completed copy of Form 1 ~ Email First reports to • • • • You can also contact Paul Donovan at (802) 828-2994 or for further information.

• • • • • • • • • • • • • • • • Form 28 – Notice of Change in Compensation Rate for Injuries after 7/1/86 – Last Revised 5/18 For prior years please contact the Department at (802) 828-2286 or • Form 28a – Notice of Change in Compensation Rate for Injuries before 7/1/86 – Last Revised 6/13 For prior years please contact the Department at (802) 828-2286 or • • • • • • • • • • • • • This report must be filed within 15 days of completion of the mediation. If you want to submit this form electronically please save it and attach it to an e-mail to. Vocational Rehabilitation Forms • • • • • • • • • • • • • •.

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