Fla. Admin. Code Ann. R. 69L-10.019 - Forms

The following forms are incorporated by reference into these rules and are available from and shall be filed with: SDTF, Division of Workers' Compensation, 1579 Summit Lake Drive, Tallahassee, FL 32317.

(1) DFS Form DFS-F1-SDF-1 - Proof of Claim (Rev. 3/09).
(2) DFS Form DFS-F1-SDF-2 -Reimbursement Request (Rev. 3/09).

Notes

Fla. Admin. Code Ann. R. 69L-10.019

Rulemaking Authority 440.49(7), 440.591 FS. Law Implemented 440.49 FS.
New 4-19-92, Amended 8-18-93, Formerly 38F-10.019, 4L-10.019, Amended 3-16-09.

New 4-19-92, Amended 8-18-93, Formerly 38F-10.019, 4L-10.019, Amended 3-16-09.

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