Fillable wage statement form

Description
Instructions: The employer should complete and sign this Wage Statement unless the injured worker is self-employed or unemployed. If the injured worker is self-employed or unemployed, both the Wage Statement and the affidavit must be completed. Failure to file wage statements may delay or stop compensation. The affidavit below may be sworn to without cost before a deputy in a BWC local customer service office. I...
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Fillable wage statement form

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