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Maryland WC Forms

A collection of workers' compensation forms which are authorized to be used in the state of Maryland.
  PDF (0KB) Forms Property & Casualty

Vehicle Repair Order (Spanish)

Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
  PDF (35KB) Forms Property & Casualty

Statement As To Replacement Cost Coverage (Spanish)

A legal form stating the values used to calculate cost coverage for repair or replacement of a property loss.
  PDF (35KB) Forms Property & Casualty

Affidavit-Lightning Losses (Spanish)

This affidavit is filled out by a service provider who inspects a property and certifies lightning damage as the sole source of the loss. A notorized signature and witnesses are required.
  PDF (50KB) Forms Property & Casualty

Memorandum For Appraisal (Spanish)

Memorandum for Appraisal is used in property damage situations where insured and insurer disagree on actual cash value, and is binding on the parties as to the amount of loss.
  PDF (60KB) Forms Property & Casualty

Sworn Statement In Proof Of Loss (w/Subrogation) (Spanish)

A notarized statement of the money claimed for a loss under a property coverage policy, which includes giving insurer the right to recovery.
  PDF (75KB) Forms Property & Casualty

Employer Occupational Injury And Disease Report

Basic reporting form used by an employer to record an employee's injury or illness on the job.
  PDF (66KB) Forms Property & Casualty


Statement Of Loss With Enclosures (Spanish)

An adjuster's statement of a loss using Schedules A, B & C, that includes enclosures.
  PDF (50KB) Forms Property & Casualty

Insured's Statement In Burglary Loss (Spanish)

A written statement by the insured detailing a burglary loss claim involving a residence or automobile.
  PDF (55KB) Forms Property & Casualty

Employer Occupational Injury And Disease Report (Spanish)

Basic reporting form used by an employer to record an employee's injury or illness on the job.
  PDF (50KB) Forms Property & Casualty

Attendance Record

Provides a daily record of an employee’s attendance and provides space/codes for noting reasons for any absences.
  DOC (78KB) Forms Property & Casualty

Sworn Statement In Proof Of Loss (No Subrogation) (Spanish)

A notarized statement of the money requested for a loss under a property coverage policy.
  PDF (85KB) Forms Property & Casualty
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