1681. WC Claim Summary Form WC 4 - Alabama

  INSTRUCTIONS: ALABAMA CLAIMS SUMMARY FORM (Form WC 4)     When an Alabama employee is injured on the job, their employer is required to provide workers compensation coverage for treatment. The insurance company is ...

1682. BC/BS Expense Claim - Alabama

  INSTRUCTIONS: BLUE CROSS/BLUE SHIELD OF ALABAMA MEDICAL EXPENSE CLAIM     Those who are enrolled for medical insurance through Blue Cross/Blue Shield of Alabama should file the medical expense claim discussed in this article ...

1683. Southland Vision Claim - Alabama

  INSTRUCTIONS: SOUTHLAND VISION CLAIM FORM      Alabama public employees file the form discussed in this article to obtain reimbursement for vision treatment. This form is processed by Southland Benefit Solutio ...

1684. Southland Dental Claim - Alabama

  INSTRUCTIONS: SOUTHLAND DENTAL CLAIM FORM      Alabama public employees are enrolled with Southland Benefit Solutions for their health insurance. Those needing to make a claim for reimbursement for dental treatment shou ...

1685. Southland Hospital Cancer Claim - Alabama

  INSTRUCTIONS: SOUTHLAND NATIONAL INDEMNITY AND CANCER CLAIM FORM     Alabama current and retired public employees who have received medical care for cancer and other conditions should file a claim for medical insurance compe ...

1686. Death Benefit Claim Form - Alabama

  INSTRUCTIONS: ALABAMA DEATH BENEFIT CLAIM FORM (Form B)     When an Alabama peace officer or fireman dies, their survivors may seek death benefits from the state by filing a form B death benefit claim form. This document can ...

1687. Supplemental Claim Form - Alabama

  INSTRUCTIONS: ALABAMA SUPPLEMENTAL CLAIM (Form C)     To file a claim with the state of Alabama for supplemental expenses following an accident, you must do so within a year of the incident, or within two if the accident res ...

1688. Claim Form - Alabama

  INSTRUCTIONS: ALABAMA CLAIM FOR PERSONAL INJURY (Form A)     When involved in an incident resulting in personal injury in Alabama involving some government agency or department, you can use a form A to seek compensation. Thi ...

1689. Form 40ES Estimated Income Tax Payment Voucher - Alabama

1690. Form 40ES Estimated Income Tax Payment Voucher - Alabama