Buy Gift Cards

Order Online

Check Gift Card Balance


Notice: Trying to access array offset on value of type null in /home/customer/www/colonialcafe.com/public_html/wp-content/plugins/gravityforms/includes/fields/class-gf-field-time.php on line 293

Illinois Form 45

Illinois Form 45: Employer's First Report Of Injury

Please fill out immediately and take as many photos as possible.
  • MM slash DD slash YYYY
  • Employee's Personal Information

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Accident Information

  • :
  • MM slash DD slash YYYY
  • :
  • MM slash DD slash YYYY
  • Drop files here or
    Max. file size: 256 MB.
      Please upload all pictures taken of accident. Injuries, conditions of workplace, etc.