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  Supplemental Agreement as to Payments of Compensation

  NCWC26 $69.00
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  Supplemental Agreement to Pay Benefits

  VAWC-4A $89.00
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  Supplemental Report

  ARWCS $69.00
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  Supplemental Report of Accident

  COWC12 $89.00
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  Supplemental Report of Varying Temporary Partial Payments

  SCWC15S $69.00
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  Supplementary Report

  VAWC-3A $89.00
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  Surface Water MOR (SWMOR)

  TCEQ_SWMOR $199.00
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  Synthetic Organic Chemical (SOC) Analysis Report

  deab63ee4ded $89.00
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  TDI DWC-1: Employer’s First Report of Injury or Illness

  TDIDWC1 $89.00
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  TDI DWC-2: Employer’s Report for Reimbursement of Voluntary Payment

  TDIDWC2 $89.00
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  TDI DWC-22: Required Medical Examination Notice or Request for Order

  TDIDWC22 $89.00
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  TDI DWC-3: Employer’s Wage Statement

  TDIDWC3 $89.00
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  TDI DWC-32: Request for Designated Doctor

  TDIDWC32 $89.00
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  TDI DWC-3SD: Employer’s Wage Statement for School Districts

  TDIDWC3SD $89.00
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  TDI DWC-6: Supplemental Report of Injury

  TDIDWC6 $89.00
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  TDI DWC-69 & 73 Medical Report Package

  TDIDWC6973 $250.00