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Cgu workers compensation form 2026
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- Click ‘Get Form’ to open the cgu workers compensation form in the editor.
- Begin by filling out the Employer Details section. Enter your full name as per policy, postal address, location address, and contact information. Ensure all fields are completed accurately.
- Proceed to the Worker’s Details section. Input the worker's given name(s), surname, residential address, telephone number, date of birth, and sex. Use block letters for clarity.
- In the Injury Details section, specify where and how the injury occurred. Provide dates and times related to the injury and reporting. Include details about witnesses if applicable.
- Complete Employment Information by detailing average weekly earnings, employment status, occupation, and working patterns over the last 12 months.
- Fill in Time Lost Particulars to indicate any time lost from work due to the injury and whether a medical certificate has been received.
- Finally, review and complete the Employer’s Declaration section by printing your name, position, signing, and dating the form before submission.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2019 | 4.8 Satisfied (177 Votes) |
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This form should be given to all newly hired employees in the State of California. Its content applies to industrial injuries on or after January 1, 2013.