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Do whatever you want with a Form 22 - North Carolina Industrial Commission - NC.gov: fill, sign, print and send online instantly. Securely download your Mar 7, 2003 - Related Content - fillable ncic form 22. NC Industrial Commission Claims Administration: All current forms used by the NC Industrial Commission can be found To Employer: Making a false statement for the purpose of denying workers' compensation benefits may result in civil or criminal penalties. INSTRUCTIONS. This Aug 10, 2018 - Jun 1, 2018 - Form 19 must be filed with the NCIC and a copy must be sent to the employee along 97-22. Actual knowledge of the injury by accident claim by the employer will Third method: if the primary method and secondary methods would be unfair This is most efficiently done in a clincher agreement that ties up all liabilities 22. Form. Use Form 22A for individual income tax name/address changes. Nebraska Change Request. You may fax this request to 402-471-5927, or mail it to: 22. Form. Use Form 22A for individual income tax name/address changes. Nebraska Change Request. You may fax this request to 402-471-5927, or mail it to: