UCSC Risk Services - Forms

Alphabetical List of Topics

Workers' Compensation

Claim Reporting

Insurance Programs

Certificates of Insurance

Event Insurance

Forms

Need Workers' Comp Help?
Call 831-459-2850

Other Risk & Insurance Help
Call 831-459-5154

Fax 831-459-3268
risk@ucsc.edu

© UC Santa Cruz

Risk Services Forms

Property and Casualty Forms		Workers’ Compensation Forms
Driver Authorization (MSWord) Request for Certificate of Insurance (MSWord) Fine Art Insurance Request (enterable pdf) Fine Art Loan Agreement Form (MSWord) Fine Art Claim Form (MSWord) Vehicle Insurance Request Form (MSWord) Transit Insurance Application – Domestic Shipments (pdf) Transit Insurance Application – Foreign Shipments (pdf) Boat Insurance Request (enterable pdf) Boat and Air Charter Reporting Form (enterable pdf)		UCSC Incident Report Form (pdf) Authorization Form for Medical Treatment (pdf) Form for Injury or Incident Investigation (pdf) Workers' Compensation Form for Volunteers (pdf) Transitional Return to Work Form (MSWord)
Insurance Forms - Purchasing Use		Waivers
One-Time Insurance Exemption Request (MSWord) Ongoing Insurance Exemption Request (MSWord)		Required Activites Waiver (pdf) Elective/Voluntary Activity Waiver (pdf) Facilities Use Athletics Waiver (pdf) Facilities Use Other Waiver (pdf)
Loss Reporting Forms		Foreign Travel
Automobile Accident or Loss Report Form (enterable pdf) Liability Loss Report Form (enterable pdf) Property Loss Report Form (enterable pdf)		Request use of a UC Vehicle in Mexico Auto Insurance Request for Mexico Travel Insurance Registration - UC Business Travel

Last revised: March 29, 2012 (jy)