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Click ‘Get Form’ to open the wc102 fillable form 2007 in the editor.
Begin by filling in the 'Board Claim No.' and the employee's identifying information, including their last name, first name, middle initial, social security number, and date of injury.
In section A, provide details about the county of injury and the employee's address. Ensure that all fields are accurately completed for both the employee and employer sections.
Move to section B where you will request production of documents. Check off the relevant forms and provide any necessary dates for wage records applicable to your claim.
Complete section C by certifying that you have sent a copy of this document to all named parties. Print your name, sign, and date the form.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (36 Votes)
2007	4.3 Satisfied (124 Votes)

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