50 State Legal Forms > Mississippi	Mississippi A-2 - Self-insured Employer Application: (revised 7/82) Mississippi A-24 - Proof Of Coverage: (revised 3/99) Mississippi B-18 - Payment Report: (revised 7/96) Mississippi B-19 - Application For Lump Sum Payment: (revised 5/01) Mississippi B-3 - Employer's First Report Of Injury Or Occupational Disease: (iaiabc Ia-1 (8/01)) - Front Side (form) Only	Select a state AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
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