Forms

Fillable Forms and Resources

  • This site supports Fillable PDF forms and can be found by searching by the state form number (SFN), title or agency that owns the form.
  • Definitions:
    • Internal Forms: Forms used by customers internal to North Dakota State Government.
    • Public Forms: Forms used by the general public or entities external to North Dakota State Government
Important: These forms MUST be downloaded to function properly (may contain automatic calculations, field validations, tab order, etc.). Using the PDF viewer within the browser disables this functionality.

Risk Management - Internal Form(s)

SFNTitleSizeDateFillable
50552 STATE RISK MANAGEMENT FUND NOTICE OF CLAIM 1463 kb 08/28/2019 Y
52376 DESTRUCTION HOLD NOTICE 70 kb 06/25/2012 Y
53424 RISK MANAGEMENT FUND CONTRIBUTION DISCOUNT PROG APPLICATION 482 kb 03/21/2019 Y
53425 RMWCP PREMIUM REDUCTION PROGRAM APPLICATION 907 kb 03/25/2022 Y
53758 DESIGNATED MEDICAL PROVIDER 194 kb 06/10/2013 Y
58571 APPLICATION TO REQUIRE A MORE STRINGENT INDEMNIFICATION PROV 471 kb 07/11/2013 Y
61580 REQUEST FOR LEGAL DEFENSE AND INDEMNIFICATION 22 kb 12/03/2018 Y