December 19, 2018

Claim Forms

The following forms may be downloaded and printed. The forms are in Adobe PDF format.

Employer's First Report of Injury

This form should be filled out by the Employer when an employee is injured, or alleges an injury, and is unable to earn full wages for five or more calendar days (Mondays through Sundays). It is the responsibility of the employer to report an alleged injury, whether or not the employer agrees with the employee's claim or not.    (INSTRUCTIONS)
 
 
 
Motor Vehicle Accident - Operators Report
 
Use this form to report a motor vehicle accident.  Mail or Deliver one copy to the local police department in the city or town where the crash occurred. Mail one copy to your insurance agency. Mail one copy to the MA RMV.
 
 
 
Motor Vehicle Accident - Request for Copy of Report
 
Use this form to request a copy of an accident/crash report filed with the Registry of Motor Vehicles.  You must print and mail the completed form to the RMV at the address indicated on the form, regardless of the manner in which it is completed.