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Forms

Application for Optional Coverage -English | Français |
Clearance Request - English | Français |
Declaration of Self-Employment (for use in Nunavut only) - English | Français |
Employer's Account Registration - English | Français |
Employer's Continuity Report - English | Français
Employer's Payroll Statement 2011/2012 - English | Français |
Employer's Repetitive Strain Questionnaire - English | Français |
Employer's Report of Fatal Injury - English | Français
Guide to Completing Employer Payroll Statement 2011/2012 -English| Français |
Payment Authorization English| Français |
Payroll Revision- English | Français |
Safe Advantage Management Practices Questionnaire 2011

Part One: Prevention - English
Part Two: Return to Work - English

WSCC Claim: Employer's Report of Injury - English | Français |

© 2010 Workers' Safety and Compensation Commission of the Northwest Territories and Nunavut