Tx annuity: Fill out & sign online

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Click ‘Get Form’ to open the tx annuity application in the editor.
Begin by entering the Employee's Name and Social Security Number in the designated fields. This information is crucial for identification purposes.
Fill in the Date of Injury and Employee's Telephone Number. Ensure these details are accurate to avoid processing delays.
Next, provide the Insurance Carrier's Name and Employer's Business Name. This helps establish the context of the claim.
Check all applicable boxes regarding payment frequency (Weekly or Monthly) and ensure that you understand the requirements outlined in Rule 131.4.
Complete the Payor's Name and Mailing Address sections, ensuring all information is legible for proper communication.
Finally, gather signatures from all required parties, including the injured employee and their representative, if applicable. Review all entries for accuracy before submission.

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