State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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WCC Voluntary Agreement Forms Memorandum - November 17, 1999


MEMORANDUM NO. 99-18

TO: Commissioners, District Administrators, Self-Insureds, Insurance Carriers, Attorneys, Unions, Medical Practitioners, and Advisory Board Members
FROM: John A. Mastropietro, Chairman
DATE: November 17, 1999
RE: VOLUNTARY AGREEMENT FORMS

The Workers’ Compensation Commission will accept the following voluntary agreement forms:

 * Please note that Memorandum No. 99-13, dated July 22, 1999, incorrectly omitted the orange form.

[NOTE: This form is available from our website or any district office.]


State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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State of Connecticut
Workers' Compensation Commission
Page last revised: November 18, 1999
Page URL: http://wcc.state.ct.us/memos/1999/99-18.htm

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