Forms
Find a Form
Child Labor/ Minor's Work Permit
- CL-1
Child Labor Application (for 14 and 15-year-old minors) - eCL-3
Online Child Labor Application (for 16 and 17-year-old workers) -
HFLL-1
An optional form for the certification of a serious health condition by a health care provider
- BB-1
Basic Business Application - DC-1
Summary of Workers' Compensation, Temporary Disability Insurance and Prepaid Healthcare Laws - LIR#27
Application for Certificate of Compliance with Section 3-122-112, HAR - UC-25
Notification of Changes - UC-86
Waiver of Employer's Experience Record - *UC-B6
Quarterly Wage, Contribution and Employment and Training Assessment Report
(*Not available online - for assistance, please call 586-8915 or 586-8916)
- HFLL-1
An optional form for the certification of a serious health condition by a health care provider
Hawaii Labor and Industrial Relations Appeals Board
- HLRB 1
Petition for Certification - HLRB 2
Petition for Clarification or Amendment of Appropriate Bargaining Unit - HLRB 3
Petition for Decertification - HLRB 4
Prohibited Practice Complaint - HLRB 5
Petition for Review of Refunds - HLRB 6
Statement of Objections to Conduct of Election - HLRB 7
Petition Relating to Financial Report of Employee Organization - HLRB 8
Petition for Determination of CB Unit and Election - HLRB 9
Petition for Referendum - HLRB 10
Petition for Decertification - HLRB 11
Unfair Labor Practice Complaint - HLRB 12
Petition for Declaratory Ruling - HLRB 13
Petition for Intervention - HLRB 14
Application for Issuance of Subpoenas - HLRB 15
Subpoena - HLRB 16
Subpoena Duces Tecum - HLRB 17
Sample Format for HIOSH Initial Conference Statement
Hawaii Occupational Safety & Health
-
Advisory Board
-
Boilers & Elevators
- Authorization for Repair/Alteration Application
- Certificate of Competency Application
- Elevator Inspection Request Form
- Installation Permit Application
- Non-Boiler External Piping (NBEP)
- Notification of Sale or Relocation of a Boiler or Pressure Vessel
- Personnel Hoist Installation Permit Application
- Certificate of Fitness for Explosives
- Certified Safety and Health Professional
- Hoisting Machine Operators Advisory Board
- Library
- FORM PCQ-Employment: Pre-Complaint Questionnaire Employment
- FORM PCQ-Access to State/Funded Services: Pre-Complaint Questionnaire
- FORM PCQ-Public Accommodation: Pre-Complaint Questionnaire
- FORM PCQ-Real Property Transaction: Pre-Complaint Questionnaire
- HC-4
Health Care Coverage Questionnaire - HC-5 2007 | 2008
Employee Notification to Employer - HC-6
Small Employers Subject To PHC / Employer's Request for Premium Supplementation - HC-61
Application For Self-Insurance Authorization
- SFC 1-99
Fire Inspection Report
Temporary Disability Insurance
- TDI-13
Application For TDI Self-Insurance - TDI-14
Equivalency Tables - TDI-15
TDI Self-Insurer's Plan Certification & Agreement
Employers
- LIR#27
Application for Certificate of Compliance with Section 3-122-112, HAR (Use this form to request a tax clearance from the Department of Labor & Industrial Relations for Professional Service Awards) - BB-1
Basic Business Application (Use this form to register your business with the Unemployment Insurance Division when employment commences) - *UC-B6
Quarterly Wage, Contribution and Employment and Training Assessment Report
(*Not available online - for assistance, please call 586-8915 or 586-8916) - UC-25
Notification of Changes (Use this form to notify the Unemployment Insurance Division of any changes to an employer's address or status of business) - UC-336
Election By Family Owned Corporation to be Excluded from coverage Under Section 383-7(20), HRS (Use this form to elect exclusion from unemployment insurance coverage of a family-owned corporation) - UC-86
Waiver of Employer's Experience Record (Use this form to request acquisition of the experience record of a predecessor employer)
UI Claimants
- UC-253
Record of Contacts Made for Work
- WC-1
Employer's Report of Industrial Injury - WC-2
Physician's Report - WC-5
Employee's Claim for Workers' Compensation Benefits - WC-5A
Dependents' Claim for Compensation - WC-14
Employee's Wage Report - WC-21
Application for Self-Insurance Authorization - WC-77
Application for Hearing - WC-77a
Response to Application for Hearing - LIR#27
Application for Certificate of Compliance with Section 3-122-112, HAR
To view and print reports you will need Adobe Acrobat Reader. If you need to download Adobe Acrobat, please click on the link.