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Code · CFR · Title 20 — Employees' Benefits · Part 702 — Administration and Procedure · § 702.202

§ 702.202. Employer's report; form and contents.

109 words·~1 min read·/us/cfr/t20/s§ 702.202·

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The employer's report of an employee's injury or death shall be in writing and on a form prescribed by the Director for this purpose, and shall contain:
(a)The name, address and business of the employer;
(b)The name, address, occupation and Social Security Number
(SSN)of the employee;
(c)The cause, nature, and other relevant circumstances of the injury or death;
(d)The year, month, day, and hour when, and the particular locality where, the injury or death occurred;
(e)Such other information as the Director may require. (Approved by the Office of Management and Budget under control numbers 1215-0031 and 1215-0063) [58 FR 68032, Dec. 23, 1993]
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§ 702.202
Employer's report; form and contents.
Fed. Reg.×2
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