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Dot statement form 2026

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  1. Click ‘Get Form’ to open the dot statement form in the editor.
  2. Begin by entering the report number and state project numbers at the top of the form. This information is crucial for tracking compliance.
  3. Fill in the prime contractor/subcontractor details, including name, date, phone number, contract number, address, and federal project number.
  4. In the 'Type of Work' section, describe the work as outlined in your proposal. This ensures clarity on what services were provided.
  5. Complete the compliance statement by filling in your name and title. Ensure you accurately report on wages paid during the specified payroll period.
  6. Indicate any legal deductions applicable under regulations and confirm that all workers have been compensated according to prevailing wage laws.
  7. Check one box regarding fringe benefits and provide detailed information if applicable. Make sure to complete any required sections on page 2.
  8. Finally, sign and date the form as a representative of both the contractor and prime contractor to certify accuracy before submission.

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14 CFR 212.10 - Application for statement of authorization.

Application for a statement of authorization shall be submitted on OST Form 4540 except that for part charters or long-term wet leases the application may beRead more

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