Claimants Statement {14-0163} | Pdf Fpdf Doc Docx | Iowa

 Iowa   Workers Compensation 
Claimants Statement {14-0163} | Pdf Fpdf Doc Docx | Iowa

Last updated: 9/20/2023

Claimants Statement {14-0163}

Start Your Free Trial $ 17.99
200 Ratings
What you get:
  • Instant access to fillable Microsoft Word or PDF forms.
  • Minimize the risk of using outdated forms and eliminate rejected fillings.
  • Largest forms database in the USA with more than 80,000 federal, state and agency forms.
  • Download, edit, auto-fill multiple forms at once in MS Word using our Forms Workflow Ribbon
  • Trusted by 1,000s of Attorneys and Legal Professionals


Form 14-0163 - CLAIMANT'S STATEMENT. The Iowa Division of Workers’ Compensation (DWC) requires a claimant who is not represented by counsel to attach this completed and signed form with any proposed settlement documents. DWC will use the information you give on this form when considering your proposed settlement.

Related forms

Our Products