# 20 C.F.R. § 702.214 (2026): Notice; form and content

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_214

## Section

- **Citation:** 20 C.F.R. § 702.214 (2026)
- **Heading:** Notice; form and content
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Title 20 CFR: Employees' Benefits / Chapter VI: OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR / Part 702: ADMINISTRATION AND PROCEDURE / Subpart B: Claims Procedures / § 702.214: § 702.214   Notice › form and content.

## Text

Notice shall be in writing on a form prescribed by the Director for this purpose; such form shall be made available to the employee or beneficiary by the employer. The notice shall be signed by the person authorized to give notice, and shall contain the name, address and Social Security Number (SSN) of the employee and, in death cases, also the SSN of the person seeking survivor benefits, and a statement of the time, place, nature and cause of the injury or death.
[58 FR 68032, Dec. 23, 1993]

## Nearby sections

- [20 C.F.R. § 702.201 (2026) § 702.201   Reports from employers of employee's injury or death.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_201.md)
- [20 C.F.R. § 702.202 (2026) § 702.202   Employer's report; form and contents.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_202.md)
- [20 C.F.R. § 702.203 (2026) § 702.203   Employer's report; how given.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_203.md)
- [20 C.F.R. § 702.204 (2026) § 702.204   Employer's report; penalty for failure to furnish and or falsifying.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_204.md)
- [20 C.F.R. § 702.205 (2026) § 702.205   Employer's report; effect of failure to report upon time limitations.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_205.md)
- [20 C.F.R. § 702.211 (2026) § 702.211   Notice of employee's injury or death; designation of responsible official.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_211.md)
- [20 C.F.R. § 702.212 (2026) § 702.212   Notice; when given; when given for certain occupational diseases.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_212.md)
- [20 C.F.R. § 702.213 (2026) § 702.213   Notice; by whom given.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_213.md)
- [20 C.F.R. § 702.214 (2026) § 702.214   Notice; form and content.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_214.md)
- [20 C.F.R. § 702.215 (2026) § 702.215   Notice; how given.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_215.md)
- [20 C.F.R. § 702.216 (2026) § 702.216   Effect of failure to give notice.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_216.md)
- [20 C.F.R. § 702.217 (2026) § 702.217   Penalty for false statement, misrepresentation.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_217.md)
- [20 C.F.R. § 702.221 (2026) § 702.221   Claims for compensation; time limitations.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_221.md)
- [20 C.F.R. § 702.222 (2026) § 702.222   Claims; exceptions to time limitations.](https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_222.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/CFR_T20_P702_S702_214. Check the current official text before relying on it. Not legal advice.