




Providing Safety Information and Resources To Members
P.O. Box 52058
Riverside, CA 92517
1440 Third Street Suite 12
Riverside, CA 92507
Guard Service Association
Phone: (951) 682-8450
Fax: (951) 369-3047
Guard Service Association
Russ Criswell, Security Industry
Scott Patterson, Recovery Industry
Sean Nelson, OSHA C.S.P.
Laura Cross-Whiteman, Administrator


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P.O. Box 52058 Riverside, CA 92517
1440 Third Street Suite 12 Riverside, CA 92507
The new online Claims Kit contains instructions and the required forms to report a workplace injury or illness.
• Workers’ Compensation Claim form (e3301/DWC-1)
• Employee’s Guide to the State Fund Medical Provider Network (e13176)
• Employer’s First Report of Occupational Injury or Illness (e3067)
Your members will have easy access to the new electronic claims kit in the gold “I’m an Employer” box on statefundca.com.
Making our Claims Kit downloadable provides your customers the convenience and flexibility to access these important documents anytime. While this change means that claims kits will no longer be mailed, customers can still request individual paper forms from our Customer Service Center at (877) 405-4545.