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OCCUPATIONAL HEALTH & SAFETY OFFICE ALG OMA DISTRICT SCHOOL BOARD 644 ALBERT STREET EAST SALT STE. MARIE, ON P6A 2K7 (705) 9457320 FAX (705) 9457301 WORKERS STATEMENT NAME: W WORKPLACE: ACCIDENT LOCATION:

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How to fill out workers statement form

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Step 1: Start by downloading the workers statement form from the official government website.

02

Step 2: Read the instructions and make sure you understand the purpose and requirements of the form.

03

Step 3: Gather all the necessary information and documents that will be needed to fill out the form.

04

Step 4: Begin by providing your personal details such as your name, contact information, and any identification numbers required.

05

Step 5: Fill in the details of your employment, including the name of your employer, your job title, and the duration of your employment.

06

Step 6: Provide details of any work-related incidents, injuries, or illnesses that you are reporting or seeking compensation for.

07

Step 7: Include any supporting documentation, such as medical records or incident reports, along with the form.

08

Step 8: Review the completed form to ensure all the information is accurate and complete.

09

Step 9: Sign and date the form.

10

Step 10: Make a copy of the completed form for your records and submit the original to the appropriate authority or department as instructed.

Who needs workers statement form?

01

Employees who have experienced work-related incidents, injuries, or illnesses and are seeking compensation.

02

Workers who want to report work-related incidents for documentation purposes.

03

Employers or HR departments who need to provide their employees with the necessary form to fill out in case of work-related incidents.

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What is workers statement form?

Workers statement form is a document that employees use to report their earnings and taxes withheld during the year.

Who is required to file workers statement form?

All employees who received income during the year and had taxes withheld are required to file a workers statement form.

How to fill out workers statement form?

Employees can fill out the workers statement form either online or on paper, providing information about their earnings and taxes withheld.

What is the purpose of workers statement form?

The purpose of the workers statement form is to report accurate information about an employee's earnings and taxes withheld to the tax authorities.

What information must be reported on workers statement form?

Information such as total earnings, taxes withheld, and any additional income or deductions must be reported on the workers statement form.

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