How to use or fill out Employers' Claim For Reimbursement with our platform
- Click ‘Get Form’ to open the Employers' Claim For Reimbursement in the editor.
- Begin by filling in the employer's details in fields 1 through 5, including the Employer's Name, Phone Number, and Tax I.D. Number. Ensure accuracy as this information is crucial for processing.
- Next, enter the employee's information in fields 6 through 8. This includes the Employee's Name and OWCP File Number. Make sure to have the employee sign where indicated.
- In section 10, specify the Work Date Range Claimed and Total Work Hours for Reimbursement. Clearly indicate the dates and hours worked to avoid any delays.
- Complete fields 11 through 13 by entering the Pay Rate Per Hour, Total Gross Amount Earned, and Amount of Reimbursement Claimed. Double-check these figures for accuracy.
- Finally, ensure that a supervisor signs and dates the form in sections 14 and 15. If there are any unsigned sections, provide an explanation in the comments area.
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