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Name File Type Programs Most Viewed
Alliance Network Acknowledgement Form DOC Workers' Compensation
Application for Coverage PDF General
Bona Fide Offer of Employment DOC Workers' Compensation
Claim Form Online: Auto HTML Auto
Claim Form Online: Property, Crime, or Equipment breakdown HTML Liability, Property
Claim Form: Auto PDF Auto
Claim Form: General Liability PDF Liability
Claim Form: Property, Crime, or Equipment Breakdown PDF Property
Coverage agreement: Auto (liability and physical damage) PDF Auto
Coverage Agreement: Liability PDF Liability
Coverage Agreement: Property PDF Property
DWC 1, Employer's First Report of Injury (FROI) (tdi.texas.gov) PDF Workers' Compensation
DWC 156, Prospective Employment Authorization and Certification Form (tdi.texas.gov) PDF Workers' Compensation
DWC 2, Employer's Report for Reimbursement of Voluntary Payment (tdi.texas.gov) PDF Workers' Compensation
DWC 3, Employer's Wage Statement (tdi.texas.gov) PDF Workers' Compensation
DWC 3, Employer's Wage Statement (App) HTML Workers' Compensation
DWC 32, Request for Designated Doctor Examination (tdi.texas.gov) PDF Workers' Compensation
DWC 33, Carrier's Request for Reduction of Income Benefits Due to Contribution (tdi.texas.gov) PDF Workers' Compensation
DWC 3ME, Employee's Multiple Employment Wage Statement (tdi.texas.gov) PDF Workers' Compensation
DWC 3MES, Declaracíon de Salario de Múltiples Trabajos de Empleado (tdi.texas.gov) (Spanish) PDF Workers' Compensation
DWC 3SD, Employer's Wage Statement for School Districts (App) HTML Workers' Compensation
DWC 3SD, Employer's Wage Statement for School Districts (tdi.texas.gov) PDF Workers' Compensation
DWC 3SDS, Declaracíon de Salario Para Escuelas de Distrito (tdi.texas.gov)(Spanish) PDF Workers' Compensation
DWC 4, Employer's Contest of Compensability (tdi.texas.gov) PDF Workers' Compensation
DWC 41, Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease (tdi.texas.gov) PDF Workers' Compensation
DWC 45, Request to Schedule, Reschedule, or Cancel a Benefit Review Conference (BRC) (tdi.texas.gov) PDF Workers' Compensation
DWC 47, Employee's Request for Advance of Benefits (tdi.texas.gov) PDF Workers' Compensation
DWC 48, Request for Travel Reimbursement (tdi.texas.gov)(English and Spanish) PDF Workers' Compensation
DWC 52, Application for Supplemental Income Benefits (tdi.texas.gov) PDF Workers' Compensation
DWC 53, Employee Request to Change Treating Doctor (tdi.texas.gov) PDF Workers' Compensation
DWC 6, Supplemental Report of Injury (App) HTML Workers' Compensation
DWC 6, Supplemental Report of Injury (tdi.texas.gov) PDF Workers' Compensation
DWC 68, Designated Doctor Examination Data Report (tdi.texas.gov) PDF Workers' Compensation
DWC 69, Report of Medical Evaluation PDF Workers' Compensation
DWC 73, Work Status Report (tdi.texas.gov) PDF Workers' Compensation
DWC 74, Description of Injured Employee's Employment (tdi.texas.gov) PDF Workers' Compensation
Electronic Fund Transfer Form DOC General
First Report of Injury (FROI) (App) HTML Workers' Compensation
Forma Médica del Lanzamiento(Spanish) DOC Workers' Compensation
GASB Statement 10 HTML General
Hartford Boiler Inspection Form PDF Property
Individual Wage Adjustment Form, C-7 (twc.state.tx.us) PDF Unemployment
Leave Election Form (No Offset) DOC Workers' Compensation
Leave Election Form (No Offset)(Spanish) DOC Workers' Compensation
Leave Election Form (Offset)(Spanish) DOC Workers' Compensation
Leave Election Form (Offset) DOC Workers' Compensation
Medical Release of Information DOC Workers' Compensation
Post-Injury Earnings Report Instructions HTML Workers' Compensation
Preauthorization Request Form DOC Workers' Compensation
Program Coordinator Change Form PDF General
Quarterly Wage Submission Form HTML Unemployment
Request for Coverage: Temporarily Vacant Buildings PDF Property
Step-by-Step through a Workers' Compensation Claim PDF Workers' Compensation
Total Wages Adjustment Form, C-5 (twc.state.tx.us) PDF Unemployment
Treatment Planning Request DOC Workers' Compensation
Treatments Requiring Preauthorization (Alliance Providers) PDF Workers' Compensation
Treatments Requiring Preauthorization (Non-Alliance Providers) PDF Workers' Compensation
WC Coverage Verification Form DOC Workers' Compensation
Weekly Inspection Log Sample - Vacant Building Inspection Log EXCEL Property