Get the free Wc113 surcharge form (colorado form) - US-State-Forms.com

WC113 SURCHARGE FORM (COLORADO FORM) ... PDF, FILLABLE, SAVABLE ... COLORADO STATE: FORM OFFICERS. COLORADO STATE USERS. PDF.

How to fill out wc113 surcharge form colorado

How to fill out wc113 surcharge form Colorado:

1. Download the wc113 surcharge form from the official website of the Colorado Department of Labor and Employment.
2. Fill out your personal information accurately, including your name, address, and contact details.
3. Provide details about your employer, such as the company name and address.
4. Indicate the date and time of the workplace injury or illness for which the surcharge is being requested.
5. Describe the circumstances surrounding the injury or illness, including how it occurred and any contributing factors.
6. Provide medical information regarding your injury or illness, including the diagnosis, treatment received, and any ongoing medical conditions resulting from the incident.
7. Attach any supporting documentation, such as medical records, accident reports, or witness statements, that can help substantiate your claim.
8. Sign and date the form, affirming that the information provided is true and accurate to the best of your knowledge.
9. Make a copy of the completed form for your records before submitting it to the Colorado Department of Labor and Employment.

Who needs wc113 surcharge form Colorado:

1. Employees who have experienced a workplace injury or illness in Colorado and wish to seek reimbursement for related expenses.
2. Individuals who have incurred medical costs or lost wages due to a work-related incident and are seeking financial assistance.
3. Employers who are required by law to provide workers' compensation benefits and are responsible for covering the cost of the surcharge.

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What is wc113 surcharge form colorado?

WC113 Surcharge Form Colorado is a form used to report and pay workers' compensation surcharges in the state of Colorado.

Who is required to file wc113 surcharge form colorado?

Employers in Colorado who are subject to workers' compensation laws are required to file WC113 Surcharge Form.

How to fill out wc113 surcharge form colorado?

WC113 Surcharge Form Colorado can be filled out online or manually by providing information about the business, number of employees, and total payroll.

What is the purpose of wc113 surcharge form colorado?

The purpose of WC113 Surcharge Form Colorado is to collect surcharges to fund the workers' compensation system in Colorado and ensure that injured workers receive benefits.

What information must be reported on wc113 surcharge form colorado?

Information such as business name, FEIN, number of employees, total payroll, and surcharge amount must be reported on WC113 Surcharge Form Colorado.