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Forms – KLA



Near Miss Information

Accident Flow Chart

Affidavit of Exempt Status (Fillable pdf)

Notice Requirements – English
Notice Requirements – Spanish

Information for Injured Employees – English (K-WC 27)
Information for Injured Employees – Spanish (K-WC 270)

Independent Contractors – Every independent, self-employed contractor should provide the employer with a completed and signed affidavit found at this link (from
Affidavit of Exempt Status – [English] [Spanish]

Employer Posting Notice (K-WC 40) – This form must be posted and maintained by the employer in one or more conspicuous places.

Department of Labor – Occupational Safety & Health Administration
OSHA 300