South Dakota Counties Map
This document displays a map of South Dakota with county boundaries and names.
PDF (36KB)
Common
Maps
Request For Medical Docs/Bills From Dr. (Spanish)
A form letter requesting medical documents and bills from a physician providing treatment to a claimant, sent with a medical authorization.
DOC (45KB)
Liability
Spanish
Workers' Compensation
Letters
PIP Wage & Salary Verification (Spanish)
This form is used to verify wage and salary information of a person who has applied for personl injury protection (PIP) benefits after an automobile accident.
PDF (35KB)
Liability
Spanish
Forms Property & Casualty
Utah WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Utah.
PDF (0KB)
Workers' Compensation
Forms Property & Casualty
Wisconsin WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Wisconsin.
PDF (0KB)
Workers' Compensation
Forms Property & Casualty
Proof Of Loss Medical Payment
A declaration by an insured person that itemizes payments made for medical services after an accident which qualify for medical expense coverage under the policy.
PDF (24KB)
Liability
Forms Property & Casualty
Oregon - Police Truck/Bus/Hazmat Crash Supplemental: 735-47 (11/11)
The Oregon Police Truck/Bus/Hazmat Crash form is a supplemental report that describes vehicle and carrier involved, and lists sequence of events.
PDF (216KB)
Auto
Liability
Crash Reports
Oregon - Police Traffic Crash Report Addition: 735-46B (9/16)
The Oregon Police Traffic Crash report appendix B lists additional passengers or witnesses, injuries, safety equipment used and contributing factors.
PDF (181KB)
Auto
Liability
Crash Reports
North Dakota - Motor Vehicle Crash Report Code Overlay: DOT 2356 (7/13)
North Dakota motor vehicle code overlay used in conjunction with the DOT crash report form.
PDF (889KB)
Auto
Liability
Crash Reports
Montana - Accident Investigation Codes
Montana accident investigation codes used to decipher an accident report.
PDF (1480KB)
Auto
Liability
Crash Reports
Nevada - Traffic Accident Report (1/04)
The Nevada motor vehicle accident report form identifies persons, vehicles and circumstances involved. It includes a crash narrative, non-motorist information, an occupant/witness supplement, and accident report codes.
PDF (299KB)
Auto
Liability
Crash Reports
New Hampshire - Motor Carrier Accident Report: DSMV 161 (7/07)
Commercial motor carrier accident report used in New Hampshire identifies vehicle and carrier, and sequence of events.
PDF (266KB)
Auto
Liability
Crash Reports
