№ files_lp_3_process_7_057214
File format: docx
Character count: 6607
File size: 30 KB
Official state workers’ compensation application form establishing the procedure and evidentiary requirements for dependents seeking fatal benefits following an employee’s death in West Virginia.
Form Number:
OIC-WC-201
Jurisdiction:
West Virginia
Program:
Workers’ Compensation
Document Type:
Application Form
Subject:
Fatal Dependents’ Benefits
Issuing Authority:
West Virginia Workers’ Compensation
Filing Deadlines:
Six months from date of death in injury claims; two years in occupational pneumoconiosis claims; one year in other occupational disease claims
Required Attachments:
Certified death certificate, autopsy report (if applicable), marriage certificate, divorce decree (if applicable), birth certificates, medical evidence of invalidism, affidavits of dependency
Notarization Requirement:
Yes
Sections:
Deceased Employee Information; Reason for Filing Claim; Dependents’ Information; Instructions
Contact Information:
OIC telephone number 888-879-9842
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
Don’t have cryptocurrency yet?
You can still complete your purchase in a few minutes:- Buy Crypto in a trusted app (Coinbase, Kraken, Cash App or any similar service).
- In the app, tap Send.
- Select network, paste our wallet address.
- Send the exact amount shown above.
The final amount may vary slightly depending on the payment method.
The file will be sent to the email address provided at checkout within 24 hours.
The product description is provided for reference. Actual content and formatting may differ slightly.
Note:
Year
Region / City:
Ottawa
Subject:
Health Insurance Coverage
Document Type:
Contractual Agreement
Organ / Institution:
Embassy of Italy
Target Audience:
Economic Operators
Period of Validity:
Five years
Year:
2023
Region / City:
Auburn, Alabama
Topic:
Employment Authorization for J-2 Dependents
Document Type:
Guidelines
Organization / Institution:
Auburn University Office of International Programs
Author:
Auburn University
Target Audience:
J-2 dependents of J-1 students and scholars
Period of Validity:
From the date of application until authorization is granted
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2016
Location:
Spangdahlem Air Base, Germany
Subject:
Early Return of Dependents
Document type:
Military memorandum and guidance package
Issuing organization:
United States Air Force, 52nd Fighter Wing
Responsible office:
Military Personnel Flight (MPF), 52 FSS/FSMPD
Approval authority:
52nd Mission Support Group Commander
Applicable regulations:
Joint Travel Regulation; DoD Directive 1315.7; AFI 36-3020
Target audience:
Air Force personnel stationed overseas with command-sponsored dependents
Effective date:
13 April 2016
Scope:
Overseas duty stations outside CONUS
Attachments:
Training package, sample letters, statements, questionnaires, regulatory excerpts
Year:
2023
Region / City:
Berkeley, CA
Subject:
Immigration forms and procedures for H-4 dependents of H-1B visa holders
Document type:
Guidelines
Organization / Institution:
University of California, Berkeley
Author:
Berkeley International Office
Target audience:
H-1B visa holders with dependents seeking to change or extend H-4 status
Effective period:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2016
Note:
Region / City
Topic:
ABAWD Policy, VA Benefits
Document Type:
Operations Memorandum
Agency / Institution:
Bureau of Operations
Author:
Inez Titus, Director
Target Audience:
CAO Executive Directors
Effective Period:
June 2016 and ongoing
Context:
This memorandum outlines the steps for CAOs to identify veterans receiving VA benefits and apply ABAWD exemptions accordingly.
Document Type:
Administrative document checklist
Subject:
Required documents for application and nomination process
Application Stages:
Stage 1 – Pre Approval; Stage 2 – After FIU Approval
Applicants Covered:
Main Applicant; Spouse; Dependent Age 18–25; Dependent Below 18
Issuing Authority:
Not specified
Related Authority:
Financial Intelligence Unit (FIU)
Required Supporting Documents:
Identification documents; civil status certificates; police records; professional references; financial and asset documentation; medical certificates
Photo Specifications:
High resolution digital photo, white background, dark clothes, no smile, ears clearly visible, no earing, no hair on forehead, hair line clearly visible, size 40mm x 50mm
Certification Requirements:
Certain documents to be printed on official letterhead with signature and stamp
Financial Documentation:
Bank reference letter with account number, opening date and ending balance; asset report certified by lawyer
Professional References:
Three professional reference letters from doctor, lawyer, accountant or other professional
Medical Documentation:
Medical certificate issued by medical examiner on official letterhead with signature and stamp
Year:
2023
Region / City:
Pennsylvania, USA
Subject:
In-State Tuition Eligibility
Document Type:
Student Letter
Institution:
Pennsylvania State University
Author:
Student (name not specified)
Intended Audience:
University Enrollment/Student Aid Office
Eligibility Category:
Veteran, Active-Duty Service Member, National Guard / Reservist, or Spouse/Dependent
Supporting Documentation Submitted:
DD 214, Command Letter, LES, DEERS Enrollment Form, DD 93, VA Dependents List, or Federal Tax Form
Date Submitted:
[Date]
Year:
2023
Region / City:
United States / Florida
Theme:
Veterans Affairs, Scholarships
Document Type:
Informational Guide
Organization:
Military & Veterans Resource Center
Author:
Not specified
Target Audience:
Veterans, Dependents, Students
Period of Validity:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Date:
March 2, 2025
Region:
Hyattsville, MD
Topic:
Pedestrian Collision Investigation
Document Type:
News Release
Organization:
Hyattsville City Police Department
Author:
Hyattsville City Police Department Public Information Office
Target Audience:
General public, media
Period of Validity:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Note:
Year
Theme:
Motorsport, Incident Reporting
Document Type:
Guide
Agency / Organization:
MSA
Target Audience:
Clerks of the Course, Stewards, Motorsport Officials
Year:
2019
Region / City:
United States
Subject:
Police use of force, Racial disparities, Fatal shootings
Document Type:
Scientific Article
Organization / Institution:
Various Universities
Author:
Cesario, J., Johnson, D.J., Terrill, W., Menifield, C.E., Shin, G., Logan, S., Worrall, J.L., Bishopp, S.A., Zinser, S.C., Fryer, R.G., Kleck, G.
Target Audience:
Academics, Social psychologists, Public administrators
Period of Validity:
2015-2019
Date of Approval:
2019
Date of Changes:
None
Year:
2023
Region / City:
Not specified
Topic:
Negative Pressure Pulmonary Oedema, General Anaesthesia, Laryngospasm
Document Type:
Case Report
Institution:
Not specified
Author:
Not specified
Target Audience:
Medical professionals, Anaesthesiologists, Pulmonologists
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2021
Region / City:
Palma, Mozambique
Theme:
Insurgency, Christian persecution, humanitarian aid
Document Type:
Report
Organization:
Aid to the Church in Need (ACN)
Author:
Not specified
Target Audience:
General public, supporters of ACN
Period of Action:
Since 2017
Date of Approval:
Not specified
Date of Changes:
Not specified
Context:
A report highlighting the ongoing violent insurgency in Mozambique and the support provided by ACN for the victims, including church reconstruction and trauma relief.
Year:
2014
Region / City:
Massachusetts
Topic:
Opioid overdose deaths
Document type:
Report
Organization:
Massachusetts Department of Public Health
Author:
Massachusetts Department of Public Health
Target audience:
Public health professionals, researchers, policy makers
Period of validity:
2013-2014
Date of approval:
August 2015
Date of changes:
Ongoing updates
Source:
Registry of Vital Records and Statistics, MDPH
Year:
2019
Source:
Reddit
Subreddit:
r/nosleep
Type of document:
Personal narrative / Fictional account
Author:
Reddit user im-a-therapist-and-my-patient-has-severe-ocd
Genre:
Horror / Psychological
Setting:
Therapist’s office, patient’s home
Content warning:
Violence, mental health issues, obsessive-compulsive disorder
Publication date:
January 23, 2019
Link:
https://www.reddit.com/r/nosleep/comments/a6805c/im_a_therapist_and_my_patient_has_severe_ocd/
Year:
1902
Region / City:
Sheridan precinct
Subject:
Road dispute, fatal shooting
Document Type:
Newspaper article
Organization / Institution:
Argus
Author:
Not specified
Target Audience:
General public
Period of Action:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Context