Posting Notices

To assist you with completing needed forms, contact information is listed below.  Any information specific to your policy can be found on your Declarations page.

Claims Reporting Hotline:
844-549-2512

Claims Address:
NL&F
P.O. Box 113247
Stamford, CT 06911-3247

AK Form 07-6120: Employer's Notice of Insurance http://labor.alaska.gov/wc/forms/wc6120.pdf
AL Form WCC#1: Workers' Compensation Notice http://labor.alabama.gov/docs/posters/wc_information.pdf
AR Form P: Workers' Compensation Instructions to Employers and Employees http://www.awcc.state.ar.us/revisedforms/formp.pdf
AR Form P: Workers' Compensation Instructions to Employers and Employees - Spanish http://www.awcc.state.ar.us/revisedforms/formpspan.pdf
AZ Employer's Compliance with Workers' Compensation Law Poster - English and Spanish https://www.azica.gov/sites/default/files/migrated_pdf/Claims_Poster_WorkersCompLawBilingual.pdf
CA Exclusion Form: Managing Members docs/ca_exclusion_form-llc-nlf.pdf
CA Exclusion Form: Officers/Directors docs/ca_exclusion_form-officers-nlf.pdf
CA Exclusion Form: Partners docs/ca_exclusion_form-partners-nlf.pdf
CA Form DWC 7: Notice to Employees - Injuries Caused by Work - English and Spanish http://www.dir.ca.gov/dwc/NoticePoster.pdf
CA Form DWC 1: Workers' Compensation Claim Form and Notice of Potential Eligibility (NOPE) http://www.dir.ca.gov/dwc/forms/ClaimForm2010.pdf
CA Employee Fact Sheet http://www.dir.ca.gov/dwc/FactSheets/Employee_FactSheet.pdf
CO Form WC49-A: Workers' Compensation Act Poster https://www.colorado.gov/pacific/sites/default/files/WC049_Work_Comp_Poster.pdf
CO Form WC49-B: Workers' Compensation Act Poster - Spanish https://www.colorado.gov/pacific/sites/default/files/WC049s_Work_Comp_Poster_Spanish.pdf
CO Form WC50: Notice to Employer of Injury Poster TEMPLATE - English and Spanish https://www.colorado.gov/pacific/sites/default/files/WC050_Notice_of_Injury_Poster.pdf
CT Notice to Employees http://wcc.state.ct.us/download/acrobat/notice.pdf
DC Form No. 1 DCWC: Notice of Compliance http://does.dc.gov/sites/default/files/dc/sites/does/publication/attachments/DOES_Notice of Compliance_1.pdf
DC Form No. 1 DCWC: Notice of Compliance - Spanish http://does.dc.gov/sites/default/files/dc/sites/does/publication/attachments/Form No 1DCWC - Spanish_1.pdf
DE Open Labor Law Poster http://dia.delawareworks.com/labor-law/documents/Labor Law Poster.pdf
DE Open Labor Law Poster - Spanish http://dia.delawareworks.com/labor-law/documents/Labor Law Poster - Spanish.pdf
FL Important Workers' Compensation Information for Florida's Employers Brochure http://www.myfloridacfo.com/division/wc/pdf/information_brochure_for_employers_ENG_print.pdf
FL Important Workers' Compensation Information for Florida's Employers Brochure - Spanish http://www.myfloridacfo.com/division/wc/pdf/information_brochure_for_employers2_SPAN_print.pdf
FL Notice of Compliance http://www.myfloridacfo.com/Division/WC/pdf/WC-Broken-Arm-Poster-Final-March-2010.pdf
FL Notice of Compliance - Spanish http://www.myfloridacfo.com/Division/WC/pdf/WC-Broken-Arm-Poster-Final-Spanish.pdf
FL Anti-Fraud Notice http://www.myfloridacfo.com/Division/WC/pdf/Anti-FraudNotice.pdf
GA Form WC-BOR: Bill of Rights for the Injured Worker http://sbwc.georgia.gov/sites/sbwc.georgia.gov/files/board_forms/bor.pdf
GA Form WC-BOR: Bill of Rights for the Injured Worker - Spanish http://sbwc.georgia.gov/sites/sbwc.georgia.gov/files/board_forms/bor_sp.pdf
GA Form WC-P1: Official Notice- Workers' Compensation Panel Posting Notice http://sbwc.georgia.gov/sites/sbwc.georgia.gov/files/imported/SBWC/Files/wc_p1.pdf
GA Form WC-P1: Official Notice- Workers' Compensation Panel Posting Notice - Spanish http://sbwc.georgia.gov/sites/sbwc.georgia.gov/files/imported/SBWC/Files/wc_p1sp.pdf
HI Labor Law Poster - Complete (Workers' Compensation on page 1) http://labor.hawaii.gov/wp-content/uploads/2014/08/Labor-Law-Poster20140805.pdf
ID Notice Regarding Workers' Compensation ./docs/id_posting_notice-nlf.pdf
IL Form ICPN: Workers' Compensation Notice https://www2.illinois.gov/sites/iwcc/Documents/icpnFORM.pdf
IN Worker's Compensation Notice http://www.in.gov/wcb/files/POSTENGL.doc
IN Worker's Compensation Notice - Spanish http://www.in.gov/wcb/files/POSTSPAN.doc
KS K-WC 40-A: Workers' Compensation Rights and Responsibilities - English and Spanish http://www.dol.ks.gov/Files/PDF/KWC40-A.pdf
KY Workers' Compensation Notice https://www.laborposters.org/kentucky/143-workers-compensation-posting-notice-poster.htm
LA Workers' Compensation Poster http://www.laworks.net/Downloads/Posters/Workers_Comp_ltr_bw.pdf
LA Workers' Compensation Poster - Spanish http://www.laworks.net/Downloads/Posters/SPN_Workers_Comp_ltr_bw.pdf
ME WCB-90: Notice to Employees - Multiple Languages http://www.maine.gov/wcb/forms/WCB-90.pdf
MA Notice to Employees Poster* https://www.mass.gov/files/documents/2016/11/wo/f-er-poster-english.pdf
MA Notice to Employees Poster* - Spanish https://www.mass.gov/files/documents/2016/11/vi/f-er-poster-spanish.pdf
MD WCC Form C-24: Workers' Compensation in Maryland http://www.wcc.state.md.us/PDF/Publications/Emp_Notice_C24_fillable.pdf
MI WC-PUB-005: Employees - Know Your Rights http://www.michigan.gov/documents/wca/wca_WC-PUB-005_338119_7.pdf
MI WC-PUB-006: Workers' Compensation Agency Rights & Responsibilities http://www.michigan.gov/documents/wca/wca_WC-PUB-006_338137_7.pdf
MN Posting Notice* http://www.doli.state.mn.us/LS/Pdf/posters/workerscomp_poster.pdf
MN Posting Notice* - Spanish http://www.doli.state.mn.us/LS/Pdf/posters/mn_workcomp_poster_spanish.pdf
MO WC-106: Workers' Compensation Law http://www.labor.mo.gov/DWC/Forms/WC-106-AI-letter.pdf
MO WC-106-S: Workers' Compensation Law - Spanish http://labor.mo.gov/sites/default/files/pubs_forms/WC-106-S-AI-letter.pdf
MS Notice of Coverage http://www.mwcc.state.ms.us/pdf/noticeofcoverageform.pdf
MS Notice of Coverage - Spanish http://www.mwcc.state.ms.us/pdf/noticeofcoverageformsp.pdf
NC 17: Workers' Compensation Notice (and Instructions) to Injured Workers and Employers http://www.ic.nc.gov/forms/form17.pdf
NC 17S: Workers' Compensation Notice (and Instructions) to Injured Workers and Employers - Spanish http://www.ic.nc.gov/forms/forma17.pdf
NH WCP-1: Workers' Compensation Law ./docs/nh_posting_notice.pdf
NJ 16NJA: Posting Notice ./docs/nj_posting_notice.pdf
NJ 17NJ: Posting Notice - Spanish ./docs/nj_posting_notice-Spanish.pdf
NJ Preferred Provider Instructions ./docs/nj_panel.pdf
NM Notice of Accident or Occupational Disease Disablement http://www.workerscomp.state.nm.us/pdf/noa.pdf
NM Posting Notice - 11x17 (1 page) http://www.workerscomp.state.nm.us/pdf/poster11x17.pdf
NM Posting Notice - 8 1/2 x 11 (2 pages) http://www.workerscomp.state.nm.us/pdf/poster8x11.pdf
NV D1: Brief Description of Your Rights and Benefits http://business.nv.gov/uploadedFiles/business.nv.gov/content/Business/Workers Compensation (D-1).pdf
NV D22: Notice to Employees http://business.nv.gov/uploadedFiles/business.nv.gov/content/Business/Workers Compensation (D-22).pdf
NY C-105: Notice of Compliance - English and Spanish ./docs/ny_posting_notice.pdf
NY C-105.1: Acknowledgment of Workers' Compensation Law ./docs/ny_c1051.pdf
OR 1188: Notice of Compliance Copies can be ordered from: http://wcd.oregon.gov/employer/Pages/noc-poster.aspx
OK CC-Form-1A: Workers' Compensation Notice
and Instruction to Employers and Employees
http://ok.gov/wcc/documents/CC-Form-1A - English_(6-19-14).pdf
OK CC-Form-1A: Workers' Compensation Notice
and Instruction to Employers and Employees - Spanish
http://ok.gov/wcc/documents/CC-Form-1A - SPANISH  (06-19-14).pdf
PA LIBC-500: Workers' Compensation Insurance Posting ./docs/pa_posting_notice.pdf
PA Designated Physicians Program Acknowledgment ./docs/pa_acknowledgment.pdf
PA Designated Physicians Program and General Workers' Compensation Instructions ./docs/pa_instructions.pdf
PA Workers' Compensation Information ./docs/pa_information.pdf
RI DWC-8: Posting Notice of Workers' Compensation Act http://www.dlt.ri.gov/wc/pdfs/Forms/Employer/dwc_08_Poster.pdf
RI DWC-8 S: Posting Notice of Workers' Compensation Act - Spanish http://www.dlt.ri.gov/wc/pdfs/Forms/Employer/dwc_08_SpanPoster.pdf
SC Workers' Compensation Compliance Poster http://www.wcc.sc.gov/complianceposter/Pages/default.aspx
SD Safety Poster http://dlr.sd.gov/employment_laws/posting_requirements.aspx
TN LB-0922: Workers' Compensation Insurance https://www.tn.gov/content/dam/tn/workforce/documents/injuries/bureau-services-forms/WC_Certificate.pdf
TN LB-0922: Workers' Compensation Insurance - Spanish https://www.tn.gov/content/dam/tn/workforce/documents/injuries/bureau-services-forms/WC_Certificate_sp.pdf
TX Notice 6: Notice to Employees Concerning Workers' Compensation in Texas* http://www.tdi.texas.gov/forms/dwc/notice6.pdf
TX Notice 6: Notice to Employees - Spanish* http://www.tdi.texas.gov/forms/dwc/notice6s.pdf
UT Workers' Compensation Notice http://laborcommission.utah.gov/media/pdfs/industrialaccidents/pubs/poster-english.pdf
UT Workers' Compensation Notice - Spanish http://laborcommission.utah.gov/media/pdfs/industrialaccidents/pubs/poster-spanish.pdf
VA Form VWC1: Workers' Compensation Notice http://www.vwc.state.va.us/sites/default/files/documents/Employers-Workplace-Notice-Form-1.pdf
VA Form VWC1: Workers' Compensation Notice - Spanish http://www.vwc.state.va.us/sites/default/files/documents/Employers-Workplace-Notice-Spanish.pdf
VT Form 31: Employer's Liability and Workers' Compensation Notice to Employees http://labor.vermont.gov/wordpress/wp-content/uploads//Form31FillIn1.pdf
VT WC-9: Employer's Reinstatement Liability http://labor.vermont.gov/wordpress/wp-content/uploads/WC-9-Employers-Reinstatement-Poster.pdf
WV-POSTING: Workers' Compensation Notice to
Employees
./docs/wv_posting_notice.pdf

* Also available in other languages