Workers’ Compensation Wage Designation Form I acknowledge, accept and understand that the Louisiana Construction - Accept - Document - PDFSEARCH.IO

First Page	Meta Content
	Workers’ Compensation Wage Designation Form I acknowledge, accept and understand that the Louisiana Construction & Industry Self Insurers Fund has based my annual workers’ compensation premium by using $23,700 as my Add to Reading List Document Date: 2013-04-03 13:07:55 Open Document File Size: 59,03 KB Share Result on Facebook

Workers’ Compensation Wage Designation Form I acknowledge, accept and understand that the Louisiana Construction & Industry Self Insurers Fund has based my annual workers’ compensation premium by using $23,700 as myAdd to Reading List