1099-G Tax Information for Unemployment Will Be Available by January 31.

Forms

Forms
Name Division Form Number File Format
Request for Tennessee High School Equivalency Verification, Transcript or Duplicate Diploma Adult Education n/a Online
Apply for Unemployment Benefits Unemployment Insurance n/a Online
Tennessee Public High School - Duplicate Diploma Request Department of Education ED-5175 PDF
Application for Repair/Erection License Boiler Unit LB-0386 PDF
Application for Certificate of Competency/Commission Boiler Unit n/a PDF
Attendance Variance Guidelines Boiler Unit n/a PDF
Boiler Inspection Variance Guide and Checklist Boiler Unit n/a PDF
Boiler Accident Report Boiler Unit IN-0927 PDF
Boiler Installation Permit Application Boiler Unit LB-0936 PDF
Replacement of Stamped Data Form Boiler Unit NB-136 PDF
Second Hand Form Boiler Unit n/a PDF
Amusement Device Ride List Amusement Devices GS-0540 PDF
Application to Install Elevators Elevator Unit LB -0364 PDF
Application for Permit (with Itinerary) Amusement Devices GS-0540 PDF
Elevator Safety Test Report Elevator Unit LB-0313 PDF
Elevator/Escalator Accident Report Elevator Unit LB-0961 PDF
Parental Consent Form | Child Labor Laws Labor Standards LB-0355 PDF
Illegal Alien Complaint Form Labor Standards LB-0989 PDF
Request E-Verify Labor Standards n/a PDF
Violation of TN Lawful Employment Act Complaint Form Labor Standards LB-1082 PDF
Abatement Form TOSHA n/a PDF
Occupational Injury and Illness Record Keeping Forms TOSHA OSHA 300 PDF
Occupational Injury and Illness Record Keeping Forms TOSHA OSHA 300 Excel
Form C-20 | TN First Report of Injury Form - Substitute for OSHA 301 TOSHA LB-0021 PDF
Report a Safety or Health Hazard | Complaint Form TOSHA TOSHA-7 PDF
Request for Consultative Services TOSHA LB-1010 PDF
Work Search Log Unemployment Insurance - Claimants LB-1072 PDF
Appeal of Agency Decision Unemployment Insurance - Appeals LB-1069 Online
Appeal of Agency Decision Unemployment Insurance - Appeals LB-1069 PDF
Notice of Appeal Unemployment Insurance - Appeals LB-0897 PDF
Request to Withdraw Appeal Unemployment Insurance - Appeals LB-0894 PDF
Request to Subpoena Unemployment Insurance - Appeals LB-0895 PDF
Request to Reschedule Hearing Unemployment Insurance - Appeals LB-0896 PDF
Employers Report of Change Unemployment Insurance - Employers LB-0792 PDF
Report to Determine Status - Application for Employer Number Unemployment Insurance - Employers LB-0441 PDF
Report to Determine Status - State and Local Government Unemployment Insurance - Employers LB-0443 PDF
Report to Determine Status - Nonprofit Organizations, Private Primary, Secondary Schools Unemployment Insurance - Employers LB-0444 PDF
Claim for Adjustment or Refund Unemployment Insurance - Employers LB-0459 PDF
Application for Transfer of Experience Rating Record Unemployment Insurance - Employers LB-0483 PDF
Separation Notice Unemployment Insurance - Employers LB-0489 PDF
Job Order Transmittal Unemployment Insurance - Employers LB-0610 PDF
Social Security Number Correction Unemployment Insurance - Employers LB-0755 PDF
Application for Client Number (for Clients of a Professional Employer Organization) Unemployment Insurance - Employers LB-0910 PDF
Declaration of Representative Unemployment Insurance - Employers LB-0927 PDF
Electronic Funds Transfer Agreement Unemployment Insurance - Employers EA-EFTA PDF
Electronic Filing Agreement Unemployment Insurance - Employers EA-EFA PDF
Form C-20 | First Report of Injury Workers' Compensation LB-0021 PDF
Form C-22 | Notice of First Payment Workers' Compensation LB-0024 PDF
Form C-23 | Notice of Denial of Claim for Compensation Workers' Compensation LB-0283 PDF
Form C-26 | Notice of Change or Termination of Benefits Workers' Compensation LB-0285 PDF
Form C-27 | Notice of Controversy Workers' Compensation LB-0280  PDF
Form C-28 | Notice of Lawsuit Workers' Compensation LB-0284 PDF
Form C-29 | Final Report of Payment Workers' Compensation LB-0020 PDF
Form C-30a | Final Medical Report Workers' Compensation LB0383 PDF
Form C-31 | Medical Waiver and Consent Workers' Compensation LB-0379 PDF
Form C-31sp | Medical Waiver and Consent (Spanish) Workers' Compensation LB-0379s PDF
Form C-32 | Standard Form Medical Report Workers' Compensation LB-0369 PDF
Form C-33 | Case Management Notification Workers' Compensation LB-0376 PDF
Form C-34 | Form Workers' Compensation LB-0377 PDF
Form C-34 | Instructions Workers' Compensation n/a PDF
Form C-35 | Utilization Review Notification Workers' Compensation LB-0380 PDF
Form C-35a | Utilization Review Denial Appeal Workers' Compensation LB-1023 PDF
Form C-36/C-37 | Utilization Review Closure Workers' Compensation LB-0375 PDF
Form C-36/C-37 | Utilization Review Closure Form Completion Instructions Workers' Compensation n/a PDF
Form C-38 | Case Management Registration Workers' Compensation LB-0965 PDF
Form C-39 | Provider Registration for Utilization Review Workers' Compensation LB-0968 PDF
Form C-40a | Request for Assistance Workers' Compensation LB-0381 PDF
Form C-40a | Request for Assistance (Spanish) Workers' Compensation LB-0381 PDF
Form C-41 | Wage Statement Workers' Compensation LB-0384 PDF
Form C-42 | Agreement Between Employer/Employee Choice of Physician Workers' Compensation LB-0382 PDF
Form C-42 SPAgreement Between Employer/Employee Choice of Physician (Spanish) Workers' Compensation LB-0382  PDF
Form C-42g | Governmental Entities Agreement Between Employer/Employee Choice of Physician Workers' Compensation n/a PDF
Form C-43 | Permanent Total Disability Final Order Workers' Compensation LB- 0988  PDF
Form C-44 | Request for Administrative Review of a WC Specialist's Order Workers' Compensation LB-1016 PDF
Form C-47 | Medical Payment Committee Review Request Workers' Compensation LB-1017 PDF
CMUR Guidelines Workers' Compensation n/a PDF
Drug-Free Workplace Form Workers' Compensation LB-0393 PDF
Drug-Free Workplace Form (Spanish) Workers' Compensation LB-0977 PDF
I-01 | Certificate of Insurer Workers' Compensation LB-0043 PDF
I-02 | Notice of Cancellation Workers' Compensation LB-0004 PDF
I-03 | Reduction in Workforce Workers' Compensation LB-0286 PDF
I-04 | Sole Proprietor/Partner Selection Workers' Compensation LB-0228 PDF
I-05 | Sole Proprietor/Partner Withdrawal of Election Workers' Compensation LB-0287 PDF
I-06 | Corporate Officer Election Not to Accept Workers' Compensation LB-0090 PDF
I-07 | Corporate Officer Withdrawal of Election Workers' Compensation LB-0288 PDF
I-08 | Exempt Employers Notice of Acceptance Workers' Compensation LB-0014 PDF
I-09 | Exempt Employers Withdrawal of Notice Workers' Compensation LB-0289 PDF
I-10 | Notice of Waiver of Workers' Compensation Benefits for Specific Medical Conditions Workers' Compensation LB-0030 PDF
I-13 | Waiver Withdrawal Workers' Compensation LB-0290 PDF
I-14 | Common Carrier Election / Termination of Coverage Form Workers' Compensation LB-0300 PDF
I-15 | General Contractor Acceptance / Termination of Coverage Agreement Form Workers' Compensation LB-0301 PDF
I-18 | Notice of Discontinuance Workers' Compensation n/a PDF
MIR Application for a Medical Impairment Rating Workers' Compensation LB-0930 PDF
MIR Application for Appointment to the Medical Impairment Rating Registry Workers' Compensation LB-0928 PDF
MIR Medical Waiver and Consent Form Workers' Compensation LB-0929 PDF
MIR Impairment Rating Report - 5th Edition Workers' Compensation LB-0931 PDF
MIR Impairment Rating Report - 6th Edition Workers' Compensation LB-0931A PDF
Posting Notice Workers' Compensation LB-0922  PDF
Posting Notice (Spanish) Workers' Compensation LB-0922SP  PDF
Request for Investigation Workers' Compensation LB-0977 PDF
Request for Investigation (Spanish) Workers' Compensation LB-0977SP DOCX
Request for Settlement Approval Workers' Compensation LB-0932 PDF
SD1 Statistical Data Form Workers' Compensation LB 0904 PDF
Petition for Benefit Determination Workers' Compensation LB-1095 PDF
Petition for Benefit Determination (Spanish) Workers' Compensation LB-1095 PDF
Expedited Hearing Notice of Appeal Workers' Compensation LB-1099 PDF
Request for Expedited Hearing Workers' Compensation LB-1100 PDF
Request for Initial Hearing Workers' Compensation LB-1098 PDF
Dispute Certification Notice Workers' Compensation LB-1096 PDF
Medical Record Certification Workers' Compensation LB-1097 PDF
Subpoena Workers' Compensation LB-0476 PDF
Compensation Hearing Notice of Appeal Workers' Compensation LB-1103 PDF
Joint Task Force on Employee Misclassification Tip Form Workers' Compensation n/a Online
Assessment of SCSEP Host Agency Training Workforce Services LB-1080 PDF
Petition for Benefit Determination Settlement Approval Only Workers' Compensation LB-1120 PDF
Physician Certification Form Workers' Compensation LB-1109 PDF
Affidavit of Indigency Workers' Compensation LB-1108 PDF
Wage and Premium Reports Unemployment Insurance LB-0456
LB-0851
PDF
Instructions for Completing the Petition TAA & ATAA Petitions ETA-9042 PDF
Instructions for Completing the Petition (Spanish) TAA & ATAA Petitions ETA-9042A PDF
Job Search Payment Form Trade Adjustment Assistance TAA LB-1116 PDF
Job Search Allowances Application Trade Adjustment Assistance TAA LB-1117 PDF
Job Search Activity Verification Trade Adjustment Assistance TAA LB-1119 PDF
Authorization and Invoice Trade Adjustment Assistance TAA LB-1121 PDF
Affidavit for RTAA Regarding Trade Affected Separating Employer Trade Adjustment Assistance TAA LB-1069 PDF
Request for Eligibility Reemployment Trade Adjustment Assistance (RTAA) Trade Adjustment Assistance TAA LB-1053 PDF
Request for Initial Reemployment Data on RTAA Trade Adjustment Assistance TAA LB-1122 PDF
Verification of Employment for Monthly Wage Supplement Trade Adjustment Assistance TAA LB-1050 PDF
Training Facility TAA Follow-Up Notice Trade Adjustment Assistance TAA LB-0785 PDF
Taxable Wage Correction Unemployment Insurance - Employers LB-3241 PDF

 

Find what you were looking for?   Yes No