Printable Form 5020 Rhode Island 2025

Printable Form 5020 Rhode Island: What You Should Know

The information disclosed is not to include the name and home address of the employer or a person or organization working under the direction of the employer.  The information disclosed cannot be used to identify an individual. No record of the disclosure or the reason for disclosure is to be made. The following information is to be disclosed: The name(s) and contact information of the claim filing agent. The name(s) and contact info of the injured employee. The name(s) and contact info of the employer and injured employee. Identification and contact information of the injured worker.

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