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  1. ILLINOIS FORM 45: EMPLOYER'S FIRST REPORT OF INJURY Please type or print. Please send this form to: ILLINOIS WORKERS' COMPENSATION COMMISSION 4500 S. SIXTH ST. FRONTAGE RD SPRINGFIELD, IL 62703. By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries).

  2. By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries). Employers shall report to the Commission all injuries resulting in the loss of more than three scheduled workdays.

  3. Please send this form to the ILLINOIS WORKERS' COMPENSATION COMMISSION 701 S. SECOND STREET SPRINGFIELD, IL 62704. IC45 12/04 By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries).

  4. The Form 45 is available on the Commission’s website, http://www.iwcc.il.gov/forms.htm. Written reports of all job-related deaths must be made to the Commission within two working days.

  5. ILLINOIS FORM 45: EMPLOYER’S FIRST REPORT OF INJURY Please type or print. Please send this form to: ILLINOIS WORKERS’ COMPENSATION COMMISSION 4500 S. SIXTH ST. FRONTAGE ROAD, SPRINGFIELD, IL 62703-5118. By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries).

  6. ILLINOIS FORM 45: EMPLOYER'S FIRST REPORT OF INJURY. Please type or print. Please send this form to: ILLINOIS WORKERS' COMPENSATION COMMISSION 4500 S. SIXTH ST. FRONTAGE ROAD SPRINGFIELD, IL 62703-5118 By law, employers must keep accurate records of all work-related injuries and illness (except for certain minor injuries).

  7. Employers shall report to the Commission all injuries resulting in the loss of more than three scheduled workdays. Filing this form does not affect liability under the W orkers' Compensation Act and is not incriminatory in any sense. This information is confidential.

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