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COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT See instructions on reverse side before completing form. Social Security # (first, middle, last) Male Female address Birth date / City Marital status Married
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How to fill out average weekly wage at:

01
Gather all necessary income information: Before filling out the average weekly wage, it is important to gather all relevant income information. This may include pay stubs, tax documents, and any other documentation that shows your weekly earnings.
02
Calculate the total earnings: Once you have all the necessary income information, you need to calculate the total earnings over a specific period. This can be done by adding up the income earned during that period, such as a month or year, and then dividing it by the number of weeks in that period.
03
Determine any additional income sources: In some cases, you may have additional sources of income apart from your regular job. It is important to include these additional income sources when calculating the average weekly wage. This can include bonuses, commissions, or any other form of income earned during the specified period.
04
Exclude any non-recurring or irregular income: When calculating the average weekly wage, it is important to exclude any non-recurring or irregular income. This can include one-time payments, such as a tax refund or a one-time bonus, as these may not be reflective of your regular weekly earnings.
05
Use accurate and up-to-date information: Make sure to use accurate and up-to-date information when filling out the average weekly wage. This ensures that the calculation is as precise and representative of your earnings as possible.

Who needs average weekly wage at:

01
Employees applying for benefits: The average weekly wage is often required when employees are applying for certain benefits, such as workers' compensation, unemployment benefits, or disability benefits. It helps determine the amount of compensation or benefits the employee is eligible for.
02
Employers for payroll purposes: Employers may need the average weekly wage information for payroll purposes. It helps in calculating overtime pay, determining employee salary, or complying with wage and hour laws.
03
Insurance companies: Insurance companies may require the average weekly wage when determining the coverage amount for specific insurance policies. This can include disability insurance, life insurance, or long-term care insurance.
In summary, filling out the average weekly wage requires gathering income information, calculating total earnings over a specific period, considering additional income sources, and excluding non-recurring or irregular income. It is needed by employees applying for benefits, employers for payroll purposes, and insurance companies for determining coverage amounts.
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Average weekly wage is the average amount of money earned by an employee per week.
Employers are required to file average weekly wage for their employees.
Average weekly wage can be filled out by calculating the total earnings of an employee for a week and dividing it by the number of hours worked.
The purpose of average weekly wage is to determine the amount of compensation an employee is entitled to in case of injury or loss of income.
Information such as employee name, total earnings, hours worked, and any bonuses or deductions must be reported on average weekly wage.
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