Cover Sheet and Welcome Letter
Table of Contents
Instructions for Posters
Form 16 NJ A – Posting Notice (Versión en Español)
Fraud Prevention Poster (Versión en Español)
Instructions for Injury Reports
Form IA-1 – First Report of Injury or Illness
Incident Investigation Report (Versión en Español)
Supervisor’s Report of Employee Incident (Versión en Español)
Witness Statement of Injury or Incident (Versión en Español)
Instructions for Injured Worker Handouts
Injured Workers First Fill Prescription Form (Versión en Español)
Consent and Authorization for Release of Information Form (Versión en Español)
Request for Medical History Form (Versión en Español)
Direct Deposit Authorization Form (Versión en Español)
Instructions for Informational Documents
Omaha National Contact Information
Reduce Your Workers Compensation Costs
An Employer’s Guide to Workers’ Compensation in New Jersey
Instructions for General Forms
Form ERM-14 – Confidential Request for Ownership Information
Company Contacts Verification
Instructions for State-Specific Forms & Documents
Form PP-1B – NJ Notice of Election – Proprietors and Partners Workers Compensation and Employers Liability Insurance
