New Death Notification Form

The Death Notification form was reviewed at the Employer Advisory Committee meeting on November 15, 2007. We developed it to assist you with gathering the information we need after a death occurs. You can fill the form in electronically, print and then mail or fax the form to us. It’s not mandatory that you use this form, but we will appreciate it if you do. We believe it will save you and us time. We’re always looking for ways to make improvements. If you have any additional feedback, please let us know.