Substituteform rev 01 05 2026

1. Click ‘Get Form’ to open the substituteform rev 01 05 in the editor.
2. Begin by entering your Full Name in the designated field, ensuring you include your last name, followed by your first and middle names.
3. In the Social Security Number section, you may choose to enter your number; however, this is optional.
4. Fill in your Postal Location with your complete address, including street number and P.O. Box if applicable.
5. Complete the City, State, and Zip code fields accurately to ensure proper identification.
6. Review the Worker’s Certification section carefully. If all statements are true, affix your signature and date it in the provided spaces.
7. For employers, enter the Employer’s Name and Address as well as the Employer ID # if available. Ensure all information is accurate for compliance.
8. Once completed, save your document and follow any additional instructions for submission as outlined on our platform.

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