Wage dwc florida form 2025

1. Click ‘Get Form’ to open the wage DWC Florida form in our editor.
2. Begin by entering the employee's name in the designated field. Ensure you include the first, middle, and last names for accuracy.
3. If applicable, provide the concurrent employer's name and address. This is important for clarity regarding multiple employment situations.
4. Fill in your employer's name and address accurately to avoid any processing delays.
5. Record the date of the accident using the format Month-Day-Year. This is crucial for claims processing.
6. Indicate whether the wages listed are for a similar employee by selecting 'Yes' or 'No'. If yes, provide their name and occupation.
7. Complete sections detailing customary work weeks, days worked per week, and hours worked per week for both the employee and employer.
8. Report wages earned over the 13 calendar weeks preceding the accident. Fill out each week's details including days worked, hours worked, and gross pay.
9. Finally, review all entries for accuracy before submitting your completed form to your claims-handling entity.

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