Form 127 pdf 2005-2025

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The document is a form from the Commonwealth of Massachusetts Department of Industrial Accidents, specifically Form 127, which is used to compute the average weekly wage for an injured employee. It requires information about the employer, employee, injury dates, and wages earned during the 52 weeks prior to the accident. The form also includes sections for reporting dependents and any additional benefits or tips received by the employee.

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Versions	Form popularity	Fillable & printable
2013	4.8 Satisfied (121 Votes)
2005	4.4 Satisfied (93 Votes)

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