North Carolina Administrative Code
Title 11 - INSURANCE
Chapter 23 - INDUSTRIAL COMMISSION
Subchapter I - CHILDHOOD VACCINE-RELATED INJURY RULES OF THE NORTH CAROLINA INDUSTRIAL COMMISSION
Section .0100 - ADMINISTRATION
Section 23I .0102 - OFFICIAL FORMS

Universal Citation: 11 NC Admin Code 23I .0102

Current through Register Vol. 39, No. 6, September 16, 2024

The use of any printed forms related to Childhood Vaccine-Related Injury claims, other than those provided by the Commission is prohibited, except that insurance carriers, self-insurers, attorneys and other parties may reproduce forms for their own use, provided:

(1) no statement, question, or information blank contained on the Commission form is omitted from the substituted form; and

(2) the substituted form is identical in size and format with the Commission form.

Authority G.S. 130A-424; 130A-425(d);
Eff. January 20, 1995;
Amended Eff. July 1, 2014;
Recodified from 04 NCAC 10I .0102 Eff. June 1, 2018.

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