semiannual

Semi-Annual Report Information

First Half 2019 semi-annual reports are due by July 15, 2019. All companies actively participating in Safety Council are required to submit this report on time.

The form can be printed and completed HERE or completed electronically via the online form below.

Instructions for completing the Semi-annual report are attached in the above link.

If you have further questions, please email safety@medinaohchamber.com or call 330-723-8773.


Medina County Safety Council

Semi-Annual Report * FIRST HALF 2019* January 1, 2019 - June 30, 2019

DUE by July 15, 2019

Address
Address
Submitted by:
Submitted by:
Phone
Phone
If there were none between January 1, 2019 and June 30, 2019 go back to the most recent injury or illness date resulting in days away from work

*Report all information for the CURRENT SIX MONTH PERIOD ONLY: January 1, 2019 - June 30, 2019

Note: If you report a death, injury or illness resulting in days away from work in the current six month period (item 4 or 5), the most recent date of death, injury or illness must correspond with item 1.