Samples of the standard forms listed in N.J.A.C. 12:235-14.1 follow:
OFFICE OF ADMINISTRATIVE LAW NOTE: The Division of Workers' Compensation submitted 29 sample forms as part of R.1997 d.110. These forms are not reproduced herein but may be inspected at:
Office of Administrative Law
Building 9
Quakerbridge Plaza, Quakerbridge Road
PO Box 049
Trenton, NJ 08625-0049
and
Department of Labor
Division of Workers' Compensation
Sixth Floor
John Fitch Plaza
PO Box 399
Trenton, NJ 08625-0399
N.J. Admin. Code § 12:235-14.2
See: 28 New Jersey Register 4067(a), 29 New Jersey Register 799(a).
Amended by R.1998 d.152, effective 3/16/1998.
See: 30 New Jersey Register 18(a), 30 New Jersey Register 1047(b).
Administrative correction.
See: 30 New Jersey Register 1417(b).
Amended by R.1998 d.550, effective 11/16/1998.
See: 30 New Jersey Register 3155(a), 30 New Jersey Register 4055(a).
Updated the addresses.
Amended by R.2000 d.260, effective 6/19/2000.
See: 32 New Jersey Register 1144(a), 32 New Jersey Register 2245(a).