Wage Request Form G1023, Wage Request Form 2026

1. Click ‘Get Form’ to open the Wage Request Form G1023 in our editor.
2. Begin by entering the worker's name and SAIF claim number at the top of the form. Ensure accuracy as this information is crucial for processing.
3. Input the date of injury. This helps establish the timeline for wage calculations.
4. Fill in gross wages for the 52 weeks prior to the date of injury, excluding any tool rental fees. Be thorough to avoid delays.
5. Note any rate changes and include rates used for sick or vacation time in the designated fields.
6. If applicable, provide an explanation for 'other gross earnings' entries, detailing any additional income sources.
7. Indicate whether the worker receives other considerations such as subsistence or travel pay by checking 'Yes' or 'No'. If yes, specify amounts and payment frequency.
8. Complete union membership details if relevant, including local union name and number.
9. Fill in employment start date if less than 52 weeks, along with pay period begin and end dates.
10. Enter regular hours worked and corresponding base pay hourly rate. Include overtime hours worked and their respective rates as well.
11. Finally, provide preparer's name and title, sign the form, and include a contact telephone number before submitting it through our platform.

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